|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.99 |
| Max. Negotiated Rate |
$168.91 |
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: BCBS Trust/PPO |
$153.20
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$161.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$168.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: PHP Commercial |
$159.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health HMO/PPO |
$163.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.16
|
| Rate for Payer: UHC Core |
$156.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.76
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$55.01
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.69
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$57.75
|
| Rate for Payer: BCN Commercial |
$54.68
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
IP
|
$1,496.73
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$972.87 |
| Max. Negotiated Rate |
$1,347.06 |
| Rate for Payer: Aetna Commercial |
$1,272.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,221.78
|
| Rate for Payer: BCN Commercial |
$1,156.67
|
| Rate for Payer: Cash Price |
$1,197.38
|
| Rate for Payer: Cofinity Commercial |
$1,287.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,197.38
|
| Rate for Payer: Healthscope Commercial |
$1,347.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,122.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.22
|
| Rate for Payer: Nomi Health Commercial |
$1,227.32
|
| Rate for Payer: PHP Commercial |
$1,272.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.87
|
| Rate for Payer: Priority Health HMO/PPO |
$1,302.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.12
|
| Rate for Payer: UHC Core |
$1,249.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,122.55
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
OP
|
$1,496.73
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,347.06 |
| Rate for Payer: Aetna Commercial |
$1,272.22
|
| Rate for Payer: Aetna Medicare |
$389.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$467.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$467.73
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$374.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.46
|
| Rate for Payer: BCN Commercial |
$1,163.71
|
| Rate for Payer: BCN Medicare Advantage |
$374.18
|
| Rate for Payer: Cash Price |
$1,197.38
|
| Rate for Payer: Cash Price |
$1,197.38
|
| Rate for Payer: Cofinity Commercial |
$1,287.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,197.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.18
|
| Rate for Payer: Healthscope Commercial |
$1,347.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,122.55
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.89
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$430.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.22
|
| Rate for Payer: Nomi Health Commercial |
$1,227.32
|
| Rate for Payer: PACE Senior Care Partners |
$355.47
|
| Rate for Payer: PACE SWMI |
$374.18
|
| Rate for Payer: PHP Commercial |
$1,272.22
|
| Rate for Payer: PHP Medicare Advantage |
$374.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.87
|
| Rate for Payer: Priority Health HMO/PPO |
$1,302.16
|
| Rate for Payer: Priority Health Medicare |
$377.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.81
|
| Rate for Payer: Railroad Medicare Medicare |
$374.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.12
|
| Rate for Payer: UHC Core |
$1,249.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.18
|
| Rate for Payer: UHC Exchange |
$374.18
|
| Rate for Payer: UHC Medicare Advantage |
$374.18
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$374.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,122.55
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: BCBS Trust/PPO |
$708.25
|
| Rate for Payer: BCN Commercial |
$670.50
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO |
$754.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.51
|
| Rate for Payer: UHC Core |
$724.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna Medicare |
$225.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.13
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$216.91
|
| Rate for Payer: BCBS Trust/PPO |
$713.28
|
| Rate for Payer: BCN Commercial |
$674.58
|
| Rate for Payer: BCN Medicare Advantage |
$216.91
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.91
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.75
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Senior Care Partners |
$206.06
|
| Rate for Payer: PACE SWMI |
$216.91
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: PHP Medicare Advantage |
$216.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO |
$754.84
|
| Rate for Payer: Priority Health Medicare |
$219.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.31
|
| Rate for Payer: Railroad Medicare Medicare |
$216.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.51
|
| Rate for Payer: UHC Core |
$724.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.91
|
| Rate for Payer: UHC Exchange |
$216.91
|
| Rate for Payer: UHC Medicare Advantage |
$216.91
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$216.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
OP
|
$1,020.00
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$242.25 |
| Max. Negotiated Rate |
$918.00 |
| Rate for Payer: Aetna Commercial |
$867.00
|
| Rate for Payer: Aetna Medicare |
$265.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$318.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$318.75
|
| Rate for Payer: BCBS Complete |
$464.73
|
| Rate for Payer: BCBS MAPPO |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$838.54
|
| Rate for Payer: BCN Commercial |
$793.05
|
| Rate for Payer: BCN Medicare Advantage |
$255.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$877.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.00
|
| Rate for Payer: Healthscope Commercial |
$918.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.00
|
| Rate for Payer: Mclaren Medicaid |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.75
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.00
|
| Rate for Payer: Nomi Health Commercial |
$836.40
|
| Rate for Payer: PACE Senior Care Partners |
$242.25
|
| Rate for Payer: PACE SWMI |
$255.00
|
| Rate for Payer: PHP Commercial |
$867.00
|
| Rate for Payer: PHP Medicare Advantage |
$255.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: Priority Health HMO/PPO |
$887.40
|
| Rate for Payer: Priority Health Medicare |
$257.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$683.40
|
| Rate for Payer: Railroad Medicare Medicare |
$255.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.60
|
| Rate for Payer: UHC Core |
$851.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.00
|
| Rate for Payer: UHC Exchange |
$255.00
|
| Rate for Payer: UHC Medicare Advantage |
$255.00
|
| Rate for Payer: UHCCP Medicaid |
$442.57
|
| Rate for Payer: VA VA |
$255.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.00
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
IP
|
$1,020.00
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$918.00 |
| Rate for Payer: Aetna Commercial |
$867.00
|
| Rate for Payer: BCBS Trust/PPO |
$832.63
|
| Rate for Payer: BCN Commercial |
$788.26
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$877.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.00
|
| Rate for Payer: Healthscope Commercial |
$918.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.00
|
| Rate for Payer: Nomi Health Commercial |
$836.40
|
| Rate for Payer: PHP Commercial |
$867.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: Priority Health HMO/PPO |
$887.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$683.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.60
|
| Rate for Payer: UHC Core |
$851.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.00
|
|
|
HC PRESSURE WIRE
|
Facility
|
OP
|
$2,201.25
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$522.80 |
| Max. Negotiated Rate |
$1,981.12 |
| Rate for Payer: Aetna Commercial |
$1,871.06
|
| Rate for Payer: Aetna Medicare |
$572.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$687.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$687.89
|
| Rate for Payer: BCBS Complete |
$880.50
|
| Rate for Payer: BCBS MAPPO |
$550.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.65
|
| Rate for Payer: BCN Commercial |
$1,711.47
|
| Rate for Payer: BCN Medicare Advantage |
$550.31
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cofinity Commercial |
$1,893.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.31
|
| Rate for Payer: Healthscope Commercial |
$1,981.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,650.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$632.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.06
|
| Rate for Payer: Nomi Health Commercial |
$1,805.03
|
| Rate for Payer: PACE Senior Care Partners |
$522.80
|
| Rate for Payer: PACE SWMI |
$550.31
|
| Rate for Payer: PHP Commercial |
$1,871.06
|
| Rate for Payer: PHP Medicare Advantage |
$550.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.81
|
| Rate for Payer: Priority Health HMO/PPO |
$1,915.09
|
| Rate for Payer: Priority Health Medicare |
$555.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,474.84
|
| Rate for Payer: Railroad Medicare Medicare |
$550.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,937.10
|
| Rate for Payer: UHC Core |
$1,838.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.31
|
| Rate for Payer: UHC Exchange |
$550.31
|
| Rate for Payer: UHC Medicare Advantage |
$550.31
|
| Rate for Payer: VA VA |
$550.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,650.94
|
|
|
HC PRESSURE WIRE
|
Facility
|
IP
|
$2,201.25
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,430.81 |
| Max. Negotiated Rate |
$1,981.12 |
| Rate for Payer: Aetna Commercial |
$1,871.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.88
|
| Rate for Payer: BCN Commercial |
$1,701.13
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cofinity Commercial |
$1,893.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.00
|
| Rate for Payer: Healthscope Commercial |
$1,981.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,650.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.06
|
| Rate for Payer: Nomi Health Commercial |
$1,805.03
|
| Rate for Payer: PHP Commercial |
$1,871.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.81
|
| Rate for Payer: Priority Health HMO/PPO |
$1,915.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,474.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,937.10
|
| Rate for Payer: UHC Core |
$1,838.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,650.94
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$84.93
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
OP
|
$51.50
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$46.35 |
| Rate for Payer: Aetna Commercial |
$43.77
|
| Rate for Payer: Aetna Medicare |
$13.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$42.34
|
| Rate for Payer: BCN Commercial |
$40.04
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$41.20
|
| Rate for Payer: Cash Price |
$41.20
|
| Rate for Payer: Cofinity Commercial |
$44.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$46.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.62
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.77
|
| Rate for Payer: Nomi Health Commercial |
$42.23
|
| Rate for Payer: PACE Senior Care Partners |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$43.77
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.48
|
| Rate for Payer: Priority Health HMO/PPO |
$44.80
|
| Rate for Payer: Priority Health Medicare |
$13.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.51
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.32
|
| Rate for Payer: UHC Core |
$43.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.88
|
| Rate for Payer: UHC Exchange |
$12.88
|
| Rate for Payer: UHC Medicare Advantage |
$12.88
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$12.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.62
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
IP
|
$51.50
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.48 |
| Max. Negotiated Rate |
$46.35 |
| Rate for Payer: Aetna Commercial |
$43.77
|
| Rate for Payer: BCBS Trust/PPO |
$42.04
|
| Rate for Payer: BCN Commercial |
$39.80
|
| Rate for Payer: Cash Price |
$41.20
|
| Rate for Payer: Cofinity Commercial |
$44.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.20
|
| Rate for Payer: Healthscope Commercial |
$46.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.77
|
| Rate for Payer: Nomi Health Commercial |
$42.23
|
| Rate for Payer: PHP Commercial |
$43.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.48
|
| Rate for Payer: Priority Health HMO/PPO |
$44.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.32
|
| Rate for Payer: UHC Core |
$43.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.62
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
IP
|
$211.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$137.24 |
| Max. Negotiated Rate |
$190.03 |
| Rate for Payer: Aetna Commercial |
$179.47
|
| Rate for Payer: BCBS Trust/PPO |
$172.35
|
| Rate for Payer: BCN Commercial |
$163.17
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$181.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.91
|
| Rate for Payer: Healthscope Commercial |
$190.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.47
|
| Rate for Payer: Nomi Health Commercial |
$173.13
|
| Rate for Payer: PHP Commercial |
$179.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.24
|
| Rate for Payer: Priority Health HMO/PPO |
$183.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.80
|
| Rate for Payer: UHC Core |
$176.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.35
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$211.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$190.03 |
| Rate for Payer: Aetna Commercial |
$179.47
|
| Rate for Payer: Aetna Medicare |
$54.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.98
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$52.78
|
| Rate for Payer: BCBS Trust/PPO |
$173.58
|
| Rate for Payer: BCN Commercial |
$164.16
|
| Rate for Payer: BCN Medicare Advantage |
$52.78
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$181.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.78
|
| Rate for Payer: Healthscope Commercial |
$190.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.35
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.42
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.47
|
| Rate for Payer: Nomi Health Commercial |
$173.13
|
| Rate for Payer: PACE Senior Care Partners |
$50.15
|
| Rate for Payer: PACE SWMI |
$52.78
|
| Rate for Payer: PHP Commercial |
$179.47
|
| Rate for Payer: PHP Medicare Advantage |
$52.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.24
|
| Rate for Payer: Priority Health HMO/PPO |
$183.69
|
| Rate for Payer: Priority Health Medicare |
$53.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.46
|
| Rate for Payer: Railroad Medicare Medicare |
$52.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.80
|
| Rate for Payer: UHC Core |
$176.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.78
|
| Rate for Payer: UHC Exchange |
$52.78
|
| Rate for Payer: UHC Medicare Advantage |
$52.78
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$52.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.35
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$27.05
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Medicare |
$7.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.45
|
| Rate for Payer: BCBS Complete |
$11.62
|
| Rate for Payer: BCBS MAPPO |
$6.76
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCN Commercial |
$21.03
|
| Rate for Payer: BCN Medicare Advantage |
$6.76
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.76
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Mclaren Medicaid |
$11.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.10
|
| Rate for Payer: Meridian Medicaid |
$11.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: PACE Senior Care Partners |
$6.42
|
| Rate for Payer: PACE SWMI |
$6.76
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Medicare Advantage |
$6.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Medicare |
$6.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.12
|
| Rate for Payer: Railroad Medicare Medicare |
$6.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.76
|
| Rate for Payer: UHC Exchange |
$6.76
|
| Rate for Payer: UHC Medicare Advantage |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$11.06
|
| Rate for Payer: VA VA |
$6.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$27.05
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.58 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: BCBS Trust/PPO |
$22.08
|
| Rate for Payer: BCN Commercial |
$20.90
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: BCBS Trust/PPO |
$31.42
|
| Rate for Payer: BCN Commercial |
$29.75
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO |
$33.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.87
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$10.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.03
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$9.62
|
| Rate for Payer: BCBS Trust/PPO |
$31.64
|
| Rate for Payer: BCN Commercial |
$29.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.62
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.62
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$11.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.10
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PACE Senior Care Partners |
$9.14
|
| Rate for Payer: PACE SWMI |
$9.62
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$9.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO |
$33.49
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.79
|
| Rate for Payer: Railroad Medicare Medicare |
$9.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.87
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.62
|
| Rate for Payer: UHC Exchange |
$9.62
|
| Rate for Payer: UHC Medicare Advantage |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$11.99
|
| Rate for Payer: VA VA |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.08 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna Medicare |
$65.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.05
|
| Rate for Payer: BCBS Complete |
$70.23
|
| Rate for Payer: BCBS MAPPO |
$63.24
|
| Rate for Payer: BCBS Trust/PPO |
$207.96
|
| Rate for Payer: BCN Commercial |
$196.68
|
| Rate for Payer: BCN Medicare Advantage |
$63.24
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.24
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Mclaren Medicaid |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.40
|
| Rate for Payer: Meridian Medicaid |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PACE Senior Care Partners |
$60.08
|
| Rate for Payer: PACE SWMI |
$63.24
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: PHP Medicare Advantage |
$63.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health HMO/PPO |
$220.08
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.48
|
| Rate for Payer: Railroad Medicare Medicare |
$63.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.60
|
| Rate for Payer: UHC Core |
$211.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.24
|
| Rate for Payer: UHC Exchange |
$63.24
|
| Rate for Payer: UHC Medicare Advantage |
$63.24
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
| Rate for Payer: VA VA |
$63.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$164.42 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: BCBS Trust/PPO |
$206.49
|
| Rate for Payer: BCN Commercial |
$195.49
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health HMO/PPO |
$220.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.60
|
| Rate for Payer: UHC Core |
$211.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$193.80
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: Aetna Medicare |
$50.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.56
|
| Rate for Payer: BCBS Complete |
$77.52
|
| Rate for Payer: BCBS MAPPO |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$159.32
|
| Rate for Payer: BCN Commercial |
$150.68
|
| Rate for Payer: BCN Medicare Advantage |
$48.45
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.45
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: PACE Senior Care Partners |
$46.03
|
| Rate for Payer: PACE SWMI |
$48.45
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: PHP Medicare Advantage |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.97
|
| Rate for Payer: Priority Health HMO/PPO |
$168.61
|
| Rate for Payer: Priority Health Medicare |
$48.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.85
|
| Rate for Payer: Railroad Medicare Medicare |
$48.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.45
|
| Rate for Payer: UHC Exchange |
$48.45
|
| Rate for Payer: UHC Medicare Advantage |
$48.45
|
| Rate for Payer: VA VA |
$48.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$193.80
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.97 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: BCBS Trust/PPO |
$158.20
|
| Rate for Payer: BCN Commercial |
$149.77
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.97
|
| Rate for Payer: Priority Health HMO/PPO |
$168.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
