|
HC SERIAL LOOP IMPLANT
|
Facility
|
IP
|
$4,281.51
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
36100081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,782.98 |
| Max. Negotiated Rate |
$3,853.36 |
| Rate for Payer: Aetna Commercial |
$3,639.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,495.00
|
| Rate for Payer: BCN Commercial |
$3,308.75
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cofinity Commercial |
$3,682.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,425.21
|
| Rate for Payer: Healthscope Commercial |
$3,853.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,211.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,639.28
|
| Rate for Payer: Nomi Health Commercial |
$3,510.84
|
| Rate for Payer: PHP Commercial |
$3,639.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,782.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,724.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,868.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,767.73
|
| Rate for Payer: UHC Core |
$3,575.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,211.13
|
|
|
HC SERIAL LOOP RECORDER
|
Facility
|
IP
|
$10,450.82
|
|
|
Service Code
|
HCPCS C1764
|
| Hospital Charge Code |
27800025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,793.03 |
| Max. Negotiated Rate |
$9,405.74 |
| Rate for Payer: Aetna Commercial |
$8,883.20
|
| Rate for Payer: BCBS Trust/PPO |
$8,531.00
|
| Rate for Payer: BCN Commercial |
$8,076.39
|
| Rate for Payer: Cash Price |
$8,360.66
|
| Rate for Payer: Cofinity Commercial |
$8,987.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,360.66
|
| Rate for Payer: Healthscope Commercial |
$9,405.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,838.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,883.20
|
| Rate for Payer: Nomi Health Commercial |
$8,569.67
|
| Rate for Payer: PHP Commercial |
$8,883.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,793.03
|
| Rate for Payer: Priority Health HMO/PPO |
$9,092.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,002.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,196.72
|
| Rate for Payer: UHC Core |
$8,726.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,838.11
|
|
|
HC SERIAL LOOP RECORDER
|
Facility
|
OP
|
$10,450.82
|
|
|
Service Code
|
HCPCS C1764
|
| Hospital Charge Code |
27800025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,482.07 |
| Max. Negotiated Rate |
$9,405.74 |
| Rate for Payer: Aetna Commercial |
$8,883.20
|
| Rate for Payer: Aetna Medicare |
$2,717.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,265.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,265.88
|
| Rate for Payer: BCBS Complete |
$4,180.33
|
| Rate for Payer: BCBS MAPPO |
$2,612.70
|
| Rate for Payer: BCBS Trust/PPO |
$8,591.62
|
| Rate for Payer: BCN Commercial |
$8,125.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,612.70
|
| Rate for Payer: Cash Price |
$8,360.66
|
| Rate for Payer: Cofinity Commercial |
$8,987.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,360.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,612.70
|
| Rate for Payer: Healthscope Commercial |
$9,405.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,838.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,743.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,004.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,883.20
|
| Rate for Payer: Nomi Health Commercial |
$8,569.67
|
| Rate for Payer: PACE Senior Care Partners |
$2,482.07
|
| Rate for Payer: PACE SWMI |
$2,612.70
|
| Rate for Payer: PHP Commercial |
$8,883.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,612.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,793.03
|
| Rate for Payer: Priority Health HMO/PPO |
$9,092.21
|
| Rate for Payer: Priority Health Medicare |
$2,638.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,002.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2,612.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,196.72
|
| Rate for Payer: UHC Core |
$8,726.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,612.70
|
| Rate for Payer: UHC Exchange |
$2,612.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,612.70
|
| Rate for Payer: VA VA |
$2,612.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,838.11
|
|
|
HC SEROTONIN HIAA BLOOD
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 84260
|
| Hospital Charge Code |
30100421
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.82 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$17.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.81
|
| Rate for Payer: BCBS Complete |
$23.52
|
| Rate for Payer: BCBS MAPPO |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$51.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.65
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$22.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.48
|
| Rate for Payer: Meridian Medicaid |
$23.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PACE Senior Care Partners |
$15.82
|
| Rate for Payer: PACE SWMI |
$16.65
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Medicare |
$16.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: Railroad Medicare Medicare |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.65
|
| Rate for Payer: UHC Exchange |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$16.65
|
| Rate for Payer: UHCCP Medicaid |
$22.40
|
| Rate for Payer: VA VA |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC SEROTONIN HIAA BLOOD
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 84260
|
| Hospital Charge Code |
30100421
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.28 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: BCBS Trust/PPO |
$54.36
|
| Rate for Payer: BCN Commercial |
$51.46
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC SEROTONIN RELEASE ASSAY
|
Facility
|
IP
|
$345.41
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200393
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$224.52 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: BCBS Trust/PPO |
$281.96
|
| Rate for Payer: BCN Commercial |
$266.93
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.52
|
| Rate for Payer: Priority Health HMO/PPO |
$300.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.96
|
| Rate for Payer: UHC Core |
$288.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC SEROTONIN RELEASE ASSAY
|
Facility
|
OP
|
$345.41
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200393
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: Aetna Medicare |
$89.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.94
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$86.35
|
| Rate for Payer: BCBS Trust/PPO |
$283.96
|
| Rate for Payer: BCN Commercial |
$268.56
|
| Rate for Payer: BCN Medicare Advantage |
$86.35
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.35
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.67
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: PACE Senior Care Partners |
$82.03
|
| Rate for Payer: PACE SWMI |
$86.35
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: PHP Medicare Advantage |
$86.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.52
|
| Rate for Payer: Priority Health HMO/PPO |
$300.51
|
| Rate for Payer: Priority Health Medicare |
$87.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.42
|
| Rate for Payer: Railroad Medicare Medicare |
$86.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.96
|
| Rate for Payer: UHC Core |
$288.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.35
|
| Rate for Payer: UHC Exchange |
$86.35
|
| Rate for Payer: UHC Medicare Advantage |
$86.35
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$86.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC SEROTONIN RELEASE ASSAY LOVENOX
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200131
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$27.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.84
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$26.27
|
| Rate for Payer: BCBS Trust/PPO |
$86.39
|
| Rate for Payer: BCN Commercial |
$81.70
|
| Rate for Payer: BCN Medicare Advantage |
$26.27
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.27
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.58
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: PACE Senior Care Partners |
$24.96
|
| Rate for Payer: PACE SWMI |
$26.27
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: PHP Medicare Advantage |
$26.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO |
$91.42
|
| Rate for Payer: Priority Health Medicare |
$26.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.40
|
| Rate for Payer: Railroad Medicare Medicare |
$26.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.47
|
| Rate for Payer: UHC Core |
$87.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.27
|
| Rate for Payer: UHC Exchange |
$26.27
|
| Rate for Payer: UHC Medicare Advantage |
$26.27
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$26.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC SEROTONIN RELEASE ASSAY LOVENOX
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200131
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.30 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: BCBS Trust/PPO |
$85.78
|
| Rate for Payer: BCN Commercial |
$81.21
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO |
$91.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.47
|
| Rate for Payer: UHC Core |
$87.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
IP
|
$407.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$265.10 |
| Max. Negotiated Rate |
$367.06 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: BCBS Trust/PPO |
$332.92
|
| Rate for Payer: BCN Commercial |
$315.18
|
| Rate for Payer: Cash Price |
$326.27
|
| Rate for Payer: Cofinity Commercial |
$350.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.27
|
| Rate for Payer: Healthscope Commercial |
$367.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Nomi Health Commercial |
$334.43
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.10
|
| Rate for Payer: Priority Health HMO/PPO |
$354.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.90
|
| Rate for Payer: UHC Core |
$340.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.88
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
OP
|
$407.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$367.06 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna Medicare |
$106.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.45
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$101.96
|
| Rate for Payer: BCBS Trust/PPO |
$335.29
|
| Rate for Payer: BCN Commercial |
$317.10
|
| Rate for Payer: BCN Medicare Advantage |
$101.96
|
| Rate for Payer: Cash Price |
$326.27
|
| Rate for Payer: Cash Price |
$326.27
|
| Rate for Payer: Cofinity Commercial |
$350.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.96
|
| Rate for Payer: Healthscope Commercial |
$367.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.88
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.06
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Nomi Health Commercial |
$334.43
|
| Rate for Payer: PACE Senior Care Partners |
$96.86
|
| Rate for Payer: PACE SWMI |
$101.96
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: PHP Medicare Advantage |
$101.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.10
|
| Rate for Payer: Priority Health HMO/PPO |
$354.82
|
| Rate for Payer: Priority Health Medicare |
$102.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.25
|
| Rate for Payer: Railroad Medicare Medicare |
$101.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.90
|
| Rate for Payer: UHC Core |
$340.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.96
|
| Rate for Payer: UHC Exchange |
$101.96
|
| Rate for Payer: UHC Medicare Advantage |
$101.96
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$101.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.88
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: BCBS Trust/PPO |
$63.20
|
| Rate for Payer: BCN Commercial |
$59.83
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$20.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$19.36
|
| Rate for Payer: BCBS Trust/PPO |
$63.65
|
| Rate for Payer: BCN Commercial |
$60.19
|
| Rate for Payer: BCN Medicare Advantage |
$19.36
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.36
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PACE Senior Care Partners |
$18.39
|
| Rate for Payer: PACE SWMI |
$19.36
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$19.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Medicare |
$19.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: Railroad Medicare Medicare |
$19.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.36
|
| Rate for Payer: UHC Exchange |
$19.36
|
| Rate for Payer: UHC Medicare Advantage |
$19.36
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$20.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$19.36
|
| Rate for Payer: BCBS Trust/PPO |
$63.65
|
| Rate for Payer: BCN Commercial |
$60.19
|
| Rate for Payer: BCN Medicare Advantage |
$19.36
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.36
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PACE Senior Care Partners |
$18.39
|
| Rate for Payer: PACE SWMI |
$19.36
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$19.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Medicare |
$19.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: Railroad Medicare Medicare |
$19.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.36
|
| Rate for Payer: UHC Exchange |
$19.36
|
| Rate for Payer: UHC Medicare Advantage |
$19.36
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: BCBS Trust/PPO |
$63.20
|
| Rate for Payer: BCN Commercial |
$59.83
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SESAME SEED IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SESAME SEED IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SETUP 1
|
Facility
|
OP
|
$33.54
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$30.19 |
| Rate for Payer: Aetna Commercial |
$28.51
|
| Rate for Payer: Aetna Medicare |
$8.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.48
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS MAPPO |
$8.38
|
| Rate for Payer: BCBS Trust/PPO |
$27.57
|
| Rate for Payer: BCN Commercial |
$26.08
|
| Rate for Payer: BCN Medicare Advantage |
$8.38
|
| Rate for Payer: Cash Price |
$26.83
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.38
|
| Rate for Payer: Healthscope Commercial |
$30.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.51
|
| Rate for Payer: Nomi Health Commercial |
$27.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.97
|
| Rate for Payer: PACE SWMI |
$8.38
|
| Rate for Payer: PHP Commercial |
$28.51
|
| Rate for Payer: PHP Medicare Advantage |
$8.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.80
|
| Rate for Payer: Priority Health HMO/PPO |
$29.18
|
| Rate for Payer: Priority Health Medicare |
$8.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.47
|
| Rate for Payer: Railroad Medicare Medicare |
$8.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.52
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.38
|
| Rate for Payer: UHC Exchange |
$8.38
|
| Rate for Payer: UHC Medicare Advantage |
$8.38
|
| Rate for Payer: VA VA |
$8.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.16
|
|
|
HC SETUP 1
|
Facility
|
IP
|
$33.54
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$30.19 |
| Rate for Payer: Aetna Commercial |
$28.51
|
| Rate for Payer: BCBS Trust/PPO |
$27.38
|
| Rate for Payer: BCN Commercial |
$25.92
|
| Rate for Payer: Cash Price |
$26.83
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.83
|
| Rate for Payer: Healthscope Commercial |
$30.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.51
|
| Rate for Payer: Nomi Health Commercial |
$27.50
|
| Rate for Payer: PHP Commercial |
$28.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.80
|
| Rate for Payer: Priority Health HMO/PPO |
$29.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.52
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.16
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
OP
|
$60.34
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.33 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.86
|
| Rate for Payer: BCBS Complete |
$16.50
|
| Rate for Payer: BCBS MAPPO |
$15.09
|
| Rate for Payer: BCBS Trust/PPO |
$49.61
|
| Rate for Payer: BCN Commercial |
$46.91
|
| Rate for Payer: BCN Medicare Advantage |
$15.09
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.09
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Mclaren Medicaid |
$15.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.84
|
| Rate for Payer: Meridian Medicaid |
$16.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: PACE Senior Care Partners |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.09
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.22
|
| Rate for Payer: Priority Health HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Medicare |
$15.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.43
|
| Rate for Payer: Railroad Medicare Medicare |
$15.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.09
|
| Rate for Payer: UHC Exchange |
$15.09
|
| Rate for Payer: UHC Medicare Advantage |
$15.09
|
| Rate for Payer: UHCCP Medicaid |
$15.71
|
| Rate for Payer: VA VA |
$15.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
IP
|
$60.34
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.22 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: BCBS Trust/PPO |
$49.26
|
| Rate for Payer: BCN Commercial |
$46.63
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.22
|
| Rate for Payer: Priority Health HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
IP
|
$85.13
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.33 |
| Max. Negotiated Rate |
$76.62 |
| Rate for Payer: Aetna Commercial |
$72.36
|
| Rate for Payer: BCBS Trust/PPO |
$69.49
|
| Rate for Payer: BCN Commercial |
$65.79
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$73.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Healthscope Commercial |
$76.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.36
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: PHP Commercial |
$72.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.33
|
| Rate for Payer: Priority Health HMO/PPO |
$74.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.91
|
| Rate for Payer: UHC Core |
$71.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
OP
|
$85.13
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$76.62 |
| Rate for Payer: Aetna Commercial |
$72.36
|
| Rate for Payer: Aetna Medicare |
$22.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.60
|
| Rate for Payer: BCBS Complete |
$16.50
|
| Rate for Payer: BCBS MAPPO |
$21.28
|
| Rate for Payer: BCBS Trust/PPO |
$69.99
|
| Rate for Payer: BCN Commercial |
$66.19
|
| Rate for Payer: BCN Medicare Advantage |
$21.28
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$73.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.28
|
| Rate for Payer: Healthscope Commercial |
$76.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Mclaren Medicaid |
$15.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.35
|
| Rate for Payer: Meridian Medicaid |
$16.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.36
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: PACE Senior Care Partners |
$20.22
|
| Rate for Payer: PACE SWMI |
$21.28
|
| Rate for Payer: PHP Commercial |
$72.36
|
| Rate for Payer: PHP Medicare Advantage |
$21.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.33
|
| Rate for Payer: Priority Health HMO/PPO |
$74.06
|
| Rate for Payer: Priority Health Medicare |
$21.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.04
|
| Rate for Payer: Railroad Medicare Medicare |
$21.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.91
|
| Rate for Payer: UHC Core |
$71.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.28
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$21.28
|
| Rate for Payer: UHCCP Medicaid |
$15.71
|
| Rate for Payer: VA VA |
$21.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC SGOT AST
|
Facility
|
IP
|
$19.46
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$17.51 |
| Rate for Payer: Aetna Commercial |
$16.54
|
| Rate for Payer: BCBS Trust/PPO |
$15.89
|
| Rate for Payer: BCN Commercial |
$15.04
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$16.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.57
|
| Rate for Payer: Healthscope Commercial |
$17.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.54
|
| Rate for Payer: Nomi Health Commercial |
$15.96
|
| Rate for Payer: PHP Commercial |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.65
|
| Rate for Payer: Priority Health HMO/PPO |
$16.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.12
|
| Rate for Payer: UHC Core |
$16.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.60
|
|
|
HC SGOT AST
|
Facility
|
OP
|
$19.46
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$17.51 |
| Rate for Payer: Aetna Commercial |
$16.54
|
| Rate for Payer: Aetna Medicare |
$5.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.08
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$4.87
|
| Rate for Payer: BCBS Trust/PPO |
$16.00
|
| Rate for Payer: BCN Commercial |
$15.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.87
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$16.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.87
|
| Rate for Payer: Healthscope Commercial |
$17.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.60
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.11
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.54
|
| Rate for Payer: Nomi Health Commercial |
$15.96
|
| Rate for Payer: PACE Senior Care Partners |
$4.62
|
| Rate for Payer: PACE SWMI |
$4.87
|
| Rate for Payer: PHP Commercial |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$4.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.65
|
| Rate for Payer: Priority Health HMO/PPO |
$16.93
|
| Rate for Payer: Priority Health Medicare |
$4.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.04
|
| Rate for Payer: Railroad Medicare Medicare |
$4.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.12
|
| Rate for Payer: UHC Core |
$16.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.87
|
| Rate for Payer: UHC Exchange |
$4.87
|
| Rate for Payer: UHC Medicare Advantage |
$4.87
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$4.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.60
|
|
