|
HC SWEAT CHLORIDE
|
Facility
|
OP
|
$80.84
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$72.76 |
| Rate for Payer: Aetna Commercial |
$68.71
|
| Rate for Payer: Aetna Medicare |
$21.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.26
|
| Rate for Payer: BCBS Complete |
$14.96
|
| Rate for Payer: BCBS MAPPO |
$20.21
|
| Rate for Payer: BCBS Trust/PPO |
$66.46
|
| Rate for Payer: BCN Commercial |
$66.46
|
| Rate for Payer: BCN Medicare Advantage |
$20.21
|
| Rate for Payer: Cash Price |
$64.67
|
| Rate for Payer: Cofinity Commercial |
$69.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.21
|
| Rate for Payer: Healthscope Commercial |
$72.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.63
|
| Rate for Payer: Mclaren Medicaid |
$14.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.22
|
| Rate for Payer: Meridian Medicaid |
$14.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.71
|
| Rate for Payer: Nomi Health Commercial |
$66.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.63
|
| Rate for Payer: PACE Senior Care Partners |
$19.20
|
| Rate for Payer: PACE SWMI |
$20.21
|
| Rate for Payer: PHP Commercial |
$68.71
|
| Rate for Payer: PHP Medicare Advantage |
$20.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.33
|
| Rate for Payer: Priority Health Medicare |
$20.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.26
|
| Rate for Payer: Railroad Medicare Medicare |
$20.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.14
|
| Rate for Payer: UHC Core |
$67.50
|
| Rate for Payer: UHC Exchange |
$20.21
|
| Rate for Payer: UHC Medicaid |
$14.25
|
| Rate for Payer: UHC Medicare Advantage |
$20.21
|
| Rate for Payer: UHCCP Medicaid |
$14.25
|
| Rate for Payer: VA VA |
$20.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.63
|
|
|
HC SWEAT COLLECTION
|
Facility
|
OP
|
$101.12
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.83 |
| Max. Negotiated Rate |
$91.01 |
| Rate for Payer: Aetna Commercial |
$85.95
|
| Rate for Payer: Aetna Medicare |
$26.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.60
|
| Rate for Payer: BCBS Complete |
$18.72
|
| Rate for Payer: BCBS MAPPO |
$25.28
|
| Rate for Payer: BCBS Trust/PPO |
$83.13
|
| Rate for Payer: BCN Commercial |
$83.13
|
| Rate for Payer: BCN Medicare Advantage |
$25.28
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cofinity Commercial |
$86.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$91.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.84
|
| Rate for Payer: Mclaren Medicaid |
$17.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.54
|
| Rate for Payer: Meridian Medicaid |
$18.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.95
|
| Rate for Payer: Nomi Health Commercial |
$82.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.84
|
| Rate for Payer: PACE Senior Care Partners |
$24.02
|
| Rate for Payer: PACE SWMI |
$25.28
|
| Rate for Payer: PHP Commercial |
$85.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.97
|
| Rate for Payer: Priority Health Medicare |
$25.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.38
|
| Rate for Payer: Railroad Medicare Medicare |
$25.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.99
|
| Rate for Payer: UHC Core |
$84.44
|
| Rate for Payer: UHC Exchange |
$25.28
|
| Rate for Payer: UHC Medicaid |
$17.83
|
| Rate for Payer: UHC Medicare Advantage |
$25.28
|
| Rate for Payer: UHCCP Medicaid |
$17.83
|
| Rate for Payer: VA VA |
$25.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.84
|
|
|
HC SWEAT COLLECTION
|
Facility
|
IP
|
$101.12
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.38 |
| Max. Negotiated Rate |
$91.01 |
| Rate for Payer: Aetna Commercial |
$85.95
|
| Rate for Payer: BCBS Trust/PPO |
$83.52
|
| Rate for Payer: BCN Commercial |
$83.52
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cofinity Commercial |
$86.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.90
|
| Rate for Payer: Healthscope Commercial |
$91.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.95
|
| Rate for Payer: Nomi Health Commercial |
$82.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.84
|
| Rate for Payer: PHP Commercial |
$85.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.99
|
| Rate for Payer: UHC Core |
$84.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.84
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SYCAMORE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SYCAMORE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
OP
|
$32.90
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.28
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.05
|
| Rate for Payer: BCN Commercial |
$27.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.64
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PACE Senior Care Partners |
$7.81
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$8.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: UHC Exchange |
$8.22
|
| Rate for Payer: UHC Medicaid |
$5.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
| Rate for Payer: UHCCP Medicaid |
$5.80
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.93 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: BCBS Trust/PPO |
$68.74
|
| Rate for Payer: BCN Commercial |
$68.74
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.24
|
| Rate for Payer: UHC Core |
$69.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.67 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$15.41
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$68.42
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$14.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$15.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Senior Care Partners |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.41
|
| Rate for Payer: Priority Health Medicare |
$21.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.93
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.24
|
| Rate for Payer: UHC Core |
$69.50
|
| Rate for Payer: UHC Exchange |
$20.81
|
| Rate for Payer: UHC Medicaid |
$14.67
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$14.67
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.17 |
| 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 |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$42.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| 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 |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| 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: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| 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 T3 FREE
|
Facility
|
IP
|
$134.83
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.84 |
| Max. Negotiated Rate |
$121.35 |
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: BCBS Trust/PPO |
$111.36
|
| Rate for Payer: BCN Commercial |
$111.36
|
| Rate for Payer: Cash Price |
$107.86
|
| Rate for Payer: Cofinity Commercial |
$115.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.86
|
| Rate for Payer: Healthscope Commercial |
$121.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.61
|
| Rate for Payer: Nomi Health Commercial |
$110.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.12
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.65
|
| Rate for Payer: UHC Core |
$112.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.12
|
|
|
HC T3 FREE
|
Facility
|
OP
|
$134.83
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.77 |
| Max. Negotiated Rate |
$121.35 |
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna Medicare |
$35.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.13
|
| Rate for Payer: BCBS Complete |
$24.96
|
| Rate for Payer: BCBS MAPPO |
$33.71
|
| Rate for Payer: BCBS Trust/PPO |
$110.84
|
| Rate for Payer: BCN Commercial |
$110.84
|
| Rate for Payer: BCN Medicare Advantage |
$33.71
|
| Rate for Payer: Cash Price |
$107.86
|
| Rate for Payer: Cofinity Commercial |
$115.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.71
|
| Rate for Payer: Healthscope Commercial |
$121.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.12
|
| Rate for Payer: Mclaren Medicaid |
$23.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.39
|
| Rate for Payer: Meridian Medicaid |
$24.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.61
|
| Rate for Payer: Nomi Health Commercial |
$110.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.12
|
| Rate for Payer: PACE Senior Care Partners |
$32.02
|
| Rate for Payer: PACE SWMI |
$33.71
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicare Advantage |
$33.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.30
|
| Rate for Payer: Priority Health Medicare |
$34.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.84
|
| Rate for Payer: Railroad Medicare Medicare |
$33.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.65
|
| Rate for Payer: UHC Core |
$112.58
|
| Rate for Payer: UHC Exchange |
$33.71
|
| Rate for Payer: UHC Medicaid |
$23.77
|
| Rate for Payer: UHC Medicare Advantage |
$33.71
|
| Rate for Payer: UHCCP Medicaid |
$23.77
|
| Rate for Payer: VA VA |
$33.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.12
|
|
|
HC T3 REVERSE
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC T3 REVERSE
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$15.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.53
|
| Rate for Payer: BCBS Complete |
$10.98
|
| Rate for Payer: BCBS MAPPO |
$14.82
|
| Rate for Payer: BCBS Trust/PPO |
$48.75
|
| Rate for Payer: BCN Commercial |
$48.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.82
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$10.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.57
|
| Rate for Payer: Meridian Medicaid |
$10.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PACE Senior Care Partners |
$14.08
|
| Rate for Payer: PACE SWMI |
$14.82
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$14.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Medicare |
$14.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.27
|
| Rate for Payer: Railroad Medicare Medicare |
$14.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: UHC Exchange |
$14.82
|
| Rate for Payer: UHC Medicaid |
$10.45
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UHCCP Medicaid |
$10.45
|
| Rate for Payer: VA VA |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$139.41
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.03 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: BCBS Trust/PPO |
$115.14
|
| Rate for Payer: BCN Commercial |
$115.14
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Nomi Health Commercial |
$114.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$121.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.68
|
| Rate for Payer: UHC Core |
$116.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.56
|
|
|
HC T3 UPTAKE
|
Facility
|
OP
|
$139.41
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.58 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna Medicare |
$36.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.57
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: BCBS MAPPO |
$34.85
|
| Rate for Payer: BCBS Trust/PPO |
$114.61
|
| Rate for Payer: BCN Commercial |
$114.61
|
| Rate for Payer: BCN Medicare Advantage |
$34.85
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.85
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.56
|
| Rate for Payer: Mclaren Medicaid |
$24.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.60
|
| Rate for Payer: Meridian Medicaid |
$25.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Nomi Health Commercial |
$114.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PACE Senior Care Partners |
$33.11
|
| Rate for Payer: PACE SWMI |
$34.85
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: PHP Medicare Advantage |
$34.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$121.29
|
| Rate for Payer: Priority Health Medicare |
$35.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.03
|
| Rate for Payer: Railroad Medicare Medicare |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.68
|
| Rate for Payer: UHC Core |
$116.41
|
| Rate for Payer: UHC Exchange |
$34.85
|
| Rate for Payer: UHC Medicaid |
$24.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.85
|
| Rate for Payer: UHCCP Medicaid |
$24.58
|
| Rate for Payer: VA VA |
$34.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.56
|
|
|
HC T4 TOTAL
|
Facility
|
IP
|
$47.86
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: BCBS Trust/PPO |
$39.53
|
| Rate for Payer: BCN Commercial |
$39.53
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.90
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.12
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC T4 TOTAL
|
Facility
|
OP
|
$47.86
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.44 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$12.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$8.86
|
| Rate for Payer: BCBS MAPPO |
$11.96
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$39.35
|
| Rate for Payer: BCN Medicare Advantage |
$11.96
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.96
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Mclaren Medicaid |
$8.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.56
|
| Rate for Payer: Meridian Medicaid |
$8.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.90
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.96
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: PHP Medicare Advantage |
$11.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.64
|
| Rate for Payer: Priority Health Medicare |
$12.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.31
|
| Rate for Payer: Railroad Medicare Medicare |
$11.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.12
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: UHC Exchange |
$11.96
|
| Rate for Payer: UHC Medicaid |
$8.44
|
| Rate for Payer: UHC Medicare Advantage |
$11.96
|
| Rate for Payer: UHCCP Medicaid |
$8.44
|
| Rate for Payer: VA VA |
$11.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC T4 TOTAL ONLY
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100759
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC T4 TOTAL ONLY
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100759
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
OP
|
$66.86
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$60.17 |
| Rate for Payer: Aetna Commercial |
$56.83
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: BCBS Complete |
$12.38
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$54.97
|
| Rate for Payer: BCN Commercial |
$54.97
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$57.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$60.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.15
|
| Rate for Payer: Mclaren Medicaid |
$11.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.83
|
| Rate for Payer: Nomi Health Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.15
|
| Rate for Payer: PACE Senior Care Partners |
$15.88
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$56.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.17
|
| Rate for Payer: Priority Health Medicare |
$16.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.53
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.84
|
| Rate for Payer: UHC Core |
$55.83
|
| Rate for Payer: UHC Exchange |
$16.71
|
| Rate for Payer: UHC Medicaid |
$11.79
|
| Rate for Payer: UHC Medicare Advantage |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$11.79
|
| Rate for Payer: VA VA |
$16.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.15
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
IP
|
$66.86
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.53 |
| Max. Negotiated Rate |
$60.17 |
| Rate for Payer: Aetna Commercial |
$56.83
|
| Rate for Payer: BCBS Trust/PPO |
$55.22
|
| Rate for Payer: BCN Commercial |
$55.22
|
| Rate for Payer: Cash Price |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$57.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.49
|
| Rate for Payer: Healthscope Commercial |
$60.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.83
|
| Rate for Payer: Nomi Health Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.15
|
| Rate for Payer: PHP Commercial |
$56.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.84
|
| Rate for Payer: UHC Core |
$55.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.15
|
|
