|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
OP
|
$105.67
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.89 |
| Max. Negotiated Rate |
$95.10 |
| Rate for Payer: Aetna Commercial |
$89.82
|
| Rate for Payer: Aetna Medicare |
$27.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.02
|
| Rate for Payer: BCBS Complete |
$13.54
|
| Rate for Payer: BCBS MAPPO |
$26.42
|
| Rate for Payer: BCBS Trust/PPO |
$86.87
|
| Rate for Payer: BCN Commercial |
$82.16
|
| Rate for Payer: BCN Medicare Advantage |
$26.42
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cofinity Commercial |
$90.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.42
|
| Rate for Payer: Healthscope Commercial |
$95.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.25
|
| Rate for Payer: Mclaren Medicaid |
$12.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.74
|
| Rate for Payer: Meridian Medicaid |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.82
|
| Rate for Payer: Nomi Health Commercial |
$86.65
|
| Rate for Payer: PACE Senior Care Partners |
$25.10
|
| Rate for Payer: PACE SWMI |
$26.42
|
| Rate for Payer: PHP Commercial |
$89.82
|
| Rate for Payer: PHP Medicare Advantage |
$26.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.69
|
| Rate for Payer: Priority Health HMO/PPO |
$91.93
|
| Rate for Payer: Priority Health Medicare |
$26.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.80
|
| Rate for Payer: Railroad Medicare Medicare |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.99
|
| Rate for Payer: UHC Core |
$88.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.42
|
| Rate for Payer: UHC Exchange |
$26.42
|
| Rate for Payer: UHC Medicare Advantage |
$26.42
|
| Rate for Payer: UHCCP Medicaid |
$12.89
|
| Rate for Payer: VA VA |
$26.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.25
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$50.79
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$51.15
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Exchange |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$15.56
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.36 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.70
|
| Rate for Payer: BCBS Trust/PPO |
$70.77
|
| Rate for Payer: BCN Commercial |
$67.00
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.70
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PHP Commercial |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.36
|
| Rate for Payer: Priority Health HMO/PPO |
$75.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.02
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
OP
|
$86.70
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.70
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.09
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$71.28
|
| Rate for Payer: BCN Commercial |
$67.41
|
| Rate for Payer: BCN Medicare Advantage |
$21.68
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.68
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.02
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.76
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.70
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PACE Senior Care Partners |
$20.59
|
| Rate for Payer: PACE SWMI |
$21.68
|
| Rate for Payer: PHP Commercial |
$73.70
|
| Rate for Payer: PHP Medicare Advantage |
$21.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.36
|
| Rate for Payer: Priority Health HMO/PPO |
$75.43
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.09
|
| Rate for Payer: Railroad Medicare Medicare |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.68
|
| Rate for Payer: UHC Exchange |
$21.68
|
| Rate for Payer: UHC Medicare Advantage |
$21.68
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$21.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.02
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
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 PROTHROMBIN TIME
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
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 PROTIME WITH INR
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| 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 PROTIME WITH INR
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.10 |
| 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 |
$3.26
|
| 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 |
$3.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.65
|
| Rate for Payer: Meridian Medicaid |
$3.26
|
| 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 |
$3.10
|
| 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 |
$3.10
|
| Rate for Payer: VA VA |
$7.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$22.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.46
|
| Rate for Payer: BCBS Complete |
$1.65
|
| Rate for Payer: BCBS MAPPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$69.60
|
| Rate for Payer: BCN Commercial |
$65.82
|
| Rate for Payer: BCN Medicare Advantage |
$21.16
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Mclaren Medicaid |
$1.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.22
|
| Rate for Payer: Meridian Medicaid |
$1.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: PACE Senior Care Partners |
$20.11
|
| Rate for Payer: PACE SWMI |
$21.16
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$21.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO |
$73.65
|
| Rate for Payer: Priority Health Medicare |
$21.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.72
|
| Rate for Payer: Railroad Medicare Medicare |
$21.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.16
|
| Rate for Payer: UHC Exchange |
$21.16
|
| Rate for Payer: UHC Medicare Advantage |
$21.16
|
| Rate for Payer: UHCCP Medicaid |
$1.57
|
| Rate for Payer: VA VA |
$21.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.03 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: BCBS Trust/PPO |
$69.11
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO |
$73.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.13 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: BCBS Trust/PPO |
$70.49
|
| Rate for Payer: BCN Commercial |
$66.73
|
| 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: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.85
|
| 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
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$22.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.98
|
| Rate for Payer: BCBS Complete |
$18.29
|
| Rate for Payer: BCBS MAPPO |
$21.59
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$67.14
|
| Rate for Payer: BCN Medicare Advantage |
$21.59
|
| Rate for Payer: Cash Price |
$69.08
|
| 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: Health Alliance Plan Medicare Advantage |
$21.59
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Mclaren Medicaid |
$17.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.67
|
| Rate for Payer: Meridian Medicaid |
$18.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: PACE Senior Care Partners |
$20.51
|
| Rate for Payer: PACE SWMI |
$21.59
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Medicare |
$21.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.85
|
| Rate for Payer: Railroad Medicare Medicare |
$21.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.59
|
| Rate for Payer: UHC Exchange |
$21.59
|
| Rate for Payer: UHC Medicare Advantage |
$21.59
|
| Rate for Payer: UHCCP Medicaid |
$17.42
|
| Rate for Payer: VA VA |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
IP
|
$69.68
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$59.23
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$53.85
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.74
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.23
|
| Rate for Payer: Nomi Health Commercial |
$57.14
|
| Rate for Payer: PHP Commercial |
$59.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.29
|
| Rate for Payer: Priority Health HMO/PPO |
$60.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.32
|
| Rate for Payer: UHC Core |
$58.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.26
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
OP
|
$69.68
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$59.23
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$14.66
|
| Rate for Payer: BCBS MAPPO |
$17.42
|
| Rate for Payer: BCBS Trust/PPO |
$57.28
|
| Rate for Payer: BCN Commercial |
$54.18
|
| Rate for Payer: BCN Medicare Advantage |
$17.42
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.42
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.26
|
| Rate for Payer: Mclaren Medicaid |
$13.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.29
|
| Rate for Payer: Meridian Medicaid |
$14.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.23
|
| Rate for Payer: Nomi Health Commercial |
$57.14
|
| Rate for Payer: PACE Senior Care Partners |
$16.55
|
| Rate for Payer: PACE SWMI |
$17.42
|
| Rate for Payer: PHP Commercial |
$59.23
|
| Rate for Payer: PHP Medicare Advantage |
$17.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.29
|
| Rate for Payer: Priority Health HMO/PPO |
$60.62
|
| Rate for Payer: Priority Health Medicare |
$17.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.32
|
| Rate for Payer: UHC Core |
$58.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.42
|
| Rate for Payer: UHC Exchange |
$17.42
|
| Rate for Payer: UHC Medicare Advantage |
$17.42
|
| Rate for Payer: UHCCP Medicaid |
$13.96
|
| Rate for Payer: VA VA |
$17.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.26
|
|
|
HC PSA FREE
|
Facility
|
IP
|
$69.68
|
|
|
Service Code
|
CPT 84154
|
| Hospital Charge Code |
30100405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$59.23
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$53.85
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.74
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.23
|
| Rate for Payer: Nomi Health Commercial |
$57.14
|
| Rate for Payer: PHP Commercial |
$59.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.29
|
| Rate for Payer: Priority Health HMO/PPO |
$60.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.32
|
| Rate for Payer: UHC Core |
$58.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.26
|
|
|
HC PSA FREE
|
Facility
|
OP
|
$69.68
|
|
|
Service Code
|
CPT 84154
|
| Hospital Charge Code |
30100405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$59.23
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$13.96
|
| Rate for Payer: BCBS MAPPO |
$17.42
|
| Rate for Payer: BCBS Trust/PPO |
$57.28
|
| Rate for Payer: BCN Commercial |
$54.18
|
| Rate for Payer: BCN Medicare Advantage |
$17.42
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.42
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.26
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.29
|
| Rate for Payer: Meridian Medicaid |
$13.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.23
|
| Rate for Payer: Nomi Health Commercial |
$57.14
|
| Rate for Payer: PACE Senior Care Partners |
$16.55
|
| Rate for Payer: PACE SWMI |
$17.42
|
| Rate for Payer: PHP Commercial |
$59.23
|
| Rate for Payer: PHP Medicare Advantage |
$17.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.29
|
| Rate for Payer: Priority Health HMO/PPO |
$60.62
|
| Rate for Payer: Priority Health Medicare |
$17.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.32
|
| Rate for Payer: UHC Core |
$58.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.42
|
| Rate for Payer: UHC Exchange |
$17.42
|
| Rate for Payer: UHC Medicare Advantage |
$17.42
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$17.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.26
|
|
|
HC PSA TOTAL
|
Facility
|
IP
|
$69.68
|
|
|
Service Code
|
CPT 84153
|
| Hospital Charge Code |
30100403
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$59.23
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$53.85
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.74
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.23
|
| Rate for Payer: Nomi Health Commercial |
$57.14
|
| Rate for Payer: PHP Commercial |
$59.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.29
|
| Rate for Payer: Priority Health HMO/PPO |
$60.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.32
|
| Rate for Payer: UHC Core |
$58.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.26
|
|
|
HC PSA TOTAL
|
Facility
|
OP
|
$69.68
|
|
|
Service Code
|
CPT 84153
|
| Hospital Charge Code |
30100403
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$59.23
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$13.96
|
| Rate for Payer: BCBS MAPPO |
$17.42
|
| Rate for Payer: BCBS Trust/PPO |
$57.28
|
| Rate for Payer: BCN Commercial |
$54.18
|
| Rate for Payer: BCN Medicare Advantage |
$17.42
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cash Price |
$55.74
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.42
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.26
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.29
|
| Rate for Payer: Meridian Medicaid |
$13.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.23
|
| Rate for Payer: Nomi Health Commercial |
$57.14
|
| Rate for Payer: PACE Senior Care Partners |
$16.55
|
| Rate for Payer: PACE SWMI |
$17.42
|
| Rate for Payer: PHP Commercial |
$59.23
|
| Rate for Payer: PHP Medicare Advantage |
$17.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.29
|
| Rate for Payer: Priority Health HMO/PPO |
$60.62
|
| Rate for Payer: Priority Health Medicare |
$17.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.32
|
| Rate for Payer: UHC Core |
$58.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.42
|
| Rate for Payer: UHC Exchange |
$17.42
|
| Rate for Payer: UHC Medicare Advantage |
$17.42
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$17.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.26
|
|
|
HC PSEUDOANEURYSM INJECTION
|
Facility
|
OP
|
$1,039.96
|
|
|
Service Code
|
CPT 36002
|
| Hospital Charge Code |
36100094
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$246.99 |
| Max. Negotiated Rate |
$935.96 |
| Rate for Payer: Aetna Commercial |
$883.97
|
| Rate for Payer: Aetna Medicare |
$270.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$324.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$324.99
|
| Rate for Payer: BCBS Complete |
$459.89
|
| Rate for Payer: BCBS MAPPO |
$259.99
|
| Rate for Payer: BCBS Trust/PPO |
$854.95
|
| Rate for Payer: BCN Commercial |
$808.57
|
| Rate for Payer: BCN Medicare Advantage |
$259.99
|
| Rate for Payer: Cash Price |
$831.97
|
| Rate for Payer: Cash Price |
$831.97
|
| Rate for Payer: Cofinity Commercial |
$894.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$831.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.99
|
| Rate for Payer: Healthscope Commercial |
$935.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$779.97
|
| Rate for Payer: Mclaren Medicaid |
$437.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.99
|
| Rate for Payer: Meridian Medicaid |
$459.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$298.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$883.97
|
| Rate for Payer: Nomi Health Commercial |
$852.77
|
| Rate for Payer: PACE Senior Care Partners |
$246.99
|
| Rate for Payer: PACE SWMI |
$259.99
|
| Rate for Payer: PHP Commercial |
$883.97
|
| Rate for Payer: PHP Medicare Advantage |
$259.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.97
|
| Rate for Payer: Priority Health HMO/PPO |
$904.77
|
| Rate for Payer: Priority Health Medicare |
$262.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$696.77
|
| Rate for Payer: Railroad Medicare Medicare |
$259.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.16
|
| Rate for Payer: UHC Core |
$868.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.99
|
| Rate for Payer: UHC Exchange |
$259.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.99
|
| Rate for Payer: UHCCP Medicaid |
$437.96
|
| Rate for Payer: VA VA |
$259.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$779.97
|
|
|
HC PSEUDOANEURYSM INJECTION
|
Facility
|
IP
|
$1,039.96
|
|
|
Service Code
|
CPT 36002
|
| Hospital Charge Code |
36100094
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$675.97 |
| Max. Negotiated Rate |
$935.96 |
| Rate for Payer: Aetna Commercial |
$883.97
|
| Rate for Payer: BCBS Trust/PPO |
$848.92
|
| Rate for Payer: BCN Commercial |
$803.68
|
| Rate for Payer: Cash Price |
$831.97
|
| Rate for Payer: Cofinity Commercial |
$894.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$831.97
|
| Rate for Payer: Healthscope Commercial |
$935.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$779.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$883.97
|
| Rate for Payer: Nomi Health Commercial |
$852.77
|
| Rate for Payer: PHP Commercial |
$883.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.97
|
| Rate for Payer: Priority Health HMO/PPO |
$904.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$696.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.16
|
| Rate for Payer: UHC Core |
$868.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$779.97
|
|
|
HC PSEUDOCHOLINESTERASE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
30100156
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC PSEUDOCHOLINESTERASE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
30100156
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$5.97
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$5.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$5.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$5.69
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC PSG PEDS 5 AND UNDER
|
Facility
|
OP
|
$5,794.25
|
|
|
Service Code
|
CPT 95782
|
| Hospital Charge Code |
92000017
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$720.70 |
| Max. Negotiated Rate |
$5,214.82 |
| Rate for Payer: Aetna Commercial |
$4,925.11
|
| Rate for Payer: Aetna Medicare |
$1,506.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,810.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,810.70
|
| Rate for Payer: BCBS Complete |
$756.79
|
| Rate for Payer: BCBS MAPPO |
$1,448.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,763.45
|
| Rate for Payer: BCN Commercial |
$4,505.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,448.56
|
| Rate for Payer: Cash Price |
$4,635.40
|
| Rate for Payer: Cash Price |
$4,635.40
|
| Rate for Payer: Cofinity Commercial |
$4,983.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,635.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,448.56
|
| Rate for Payer: Healthscope Commercial |
$5,214.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,345.69
|
| Rate for Payer: Mclaren Medicaid |
$720.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,520.99
|
| Rate for Payer: Meridian Medicaid |
$756.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,665.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,925.11
|
| Rate for Payer: Nomi Health Commercial |
$4,751.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,376.13
|
| Rate for Payer: PACE SWMI |
$1,448.56
|
| Rate for Payer: PHP Commercial |
$4,925.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,448.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.26
|
| Rate for Payer: Priority Health HMO/PPO |
$5,041.00
|
| Rate for Payer: Priority Health Medicare |
$1,463.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,882.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,448.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,098.94
|
| Rate for Payer: UHC Core |
$4,838.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,448.56
|
| Rate for Payer: UHC Exchange |
$1,448.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,448.56
|
| Rate for Payer: UHCCP Medicaid |
$720.70
|
| Rate for Payer: VA VA |
$1,448.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,345.69
|
|
|
HC PSG PEDS 5 AND UNDER
|
Facility
|
IP
|
$5,794.25
|
|
|
Service Code
|
CPT 95782
|
| Hospital Charge Code |
92000017
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$3,766.26 |
| Max. Negotiated Rate |
$5,214.82 |
| Rate for Payer: Aetna Commercial |
$4,925.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,729.85
|
| Rate for Payer: BCN Commercial |
$4,477.80
|
| Rate for Payer: Cash Price |
$4,635.40
|
| Rate for Payer: Cofinity Commercial |
$4,983.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,635.40
|
| Rate for Payer: Healthscope Commercial |
$5,214.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,345.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,925.11
|
| Rate for Payer: Nomi Health Commercial |
$4,751.28
|
| Rate for Payer: PHP Commercial |
$4,925.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.26
|
| Rate for Payer: Priority Health HMO/PPO |
$5,041.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,882.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,098.94
|
| Rate for Payer: UHC Core |
$4,838.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,345.69
|
|
