|
HC THSD7
|
Facility
|
IP
|
$387.97
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200493
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$270.03 |
| Max. Negotiated Rate |
$349.17 |
| Rate for Payer: Aetna Commercial |
$329.77
|
| Rate for Payer: BCBS Trust/PPO |
$320.42
|
| Rate for Payer: BCN Commercial |
$320.42
|
| Rate for Payer: Cash Price |
$310.38
|
| Rate for Payer: Cofinity Commercial |
$333.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.38
|
| Rate for Payer: Healthscope Commercial |
$349.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$318.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.98
|
| Rate for Payer: PHP Commercial |
$329.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$337.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.41
|
| Rate for Payer: UHC Core |
$323.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.98
|
|
|
HC THSD7
|
Facility
|
OP
|
$387.97
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200493
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$349.17 |
| Rate for Payer: Aetna Commercial |
$329.77
|
| Rate for Payer: Aetna Medicare |
$100.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.24
|
| Rate for Payer: BCBS Complete |
$71.81
|
| Rate for Payer: BCBS MAPPO |
$96.99
|
| Rate for Payer: BCBS Trust/PPO |
$318.95
|
| Rate for Payer: BCN Commercial |
$318.95
|
| Rate for Payer: BCN Medicare Advantage |
$96.99
|
| Rate for Payer: Cash Price |
$310.38
|
| Rate for Payer: Cofinity Commercial |
$333.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.99
|
| Rate for Payer: Healthscope Commercial |
$349.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.98
|
| Rate for Payer: Mclaren Medicaid |
$68.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.84
|
| Rate for Payer: Meridian Medicaid |
$71.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$318.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.98
|
| Rate for Payer: PACE Senior Care Partners |
$92.14
|
| Rate for Payer: PACE SWMI |
$96.99
|
| Rate for Payer: PHP Commercial |
$329.77
|
| Rate for Payer: PHP Medicare Advantage |
$96.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$337.53
|
| Rate for Payer: Priority Health Medicare |
$97.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.03
|
| Rate for Payer: Railroad Medicare Medicare |
$96.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.41
|
| Rate for Payer: UHC Core |
$323.95
|
| Rate for Payer: UHC Exchange |
$96.99
|
| Rate for Payer: UHC Medicaid |
$68.40
|
| Rate for Payer: UHC Medicare Advantage |
$96.99
|
| Rate for Payer: UHCCP Medicaid |
$68.40
|
| Rate for Payer: VA VA |
$96.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.98
|
|
|
HC THYROGLOBULIN
|
Facility
|
IP
|
$59.05
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.10 |
| Max. Negotiated Rate |
$53.15 |
| Rate for Payer: Aetna Commercial |
$50.19
|
| Rate for Payer: BCBS Trust/PPO |
$48.77
|
| Rate for Payer: BCN Commercial |
$48.77
|
| Rate for Payer: Cash Price |
$47.24
|
| Rate for Payer: Cofinity Commercial |
$50.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.24
|
| Rate for Payer: Healthscope Commercial |
$53.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.19
|
| Rate for Payer: Nomi Health Commercial |
$48.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.29
|
| Rate for Payer: PHP Commercial |
$50.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.96
|
| Rate for Payer: UHC Core |
$49.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.29
|
|
|
HC THYROGLOBULIN
|
Facility
|
OP
|
$59.05
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$53.15 |
| Rate for Payer: Aetna Commercial |
$50.19
|
| Rate for Payer: Aetna Medicare |
$15.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.45
|
| Rate for Payer: BCBS Complete |
$10.93
|
| Rate for Payer: BCBS MAPPO |
$14.76
|
| Rate for Payer: BCBS Trust/PPO |
$48.55
|
| Rate for Payer: BCN Commercial |
$48.55
|
| Rate for Payer: BCN Medicare Advantage |
$14.76
|
| Rate for Payer: Cash Price |
$47.24
|
| Rate for Payer: Cofinity Commercial |
$50.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.76
|
| Rate for Payer: Healthscope Commercial |
$53.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.29
|
| Rate for Payer: Mclaren Medicaid |
$10.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.50
|
| Rate for Payer: Meridian Medicaid |
$10.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.19
|
| Rate for Payer: Nomi Health Commercial |
$48.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.29
|
| Rate for Payer: PACE Senior Care Partners |
$14.02
|
| Rate for Payer: PACE SWMI |
$14.76
|
| Rate for Payer: PHP Commercial |
$50.19
|
| Rate for Payer: PHP Medicare Advantage |
$14.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.37
|
| Rate for Payer: Priority Health Medicare |
$14.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.10
|
| Rate for Payer: Railroad Medicare Medicare |
$14.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.96
|
| Rate for Payer: UHC Core |
$49.31
|
| Rate for Payer: UHC Exchange |
$14.76
|
| Rate for Payer: UHC Medicaid |
$10.41
|
| Rate for Payer: UHC Medicare Advantage |
$14.76
|
| Rate for Payer: UHCCP Medicaid |
$10.41
|
| Rate for Payer: VA VA |
$14.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.29
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
IP
|
$61.44
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.76 |
| Max. Negotiated Rate |
$55.30 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$50.74
|
| Rate for Payer: Cash Price |
$49.15
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.15
|
| Rate for Payer: Healthscope Commercial |
$55.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.22
|
| Rate for Payer: Nomi Health Commercial |
$50.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.08
|
| Rate for Payer: PHP Commercial |
$52.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.07
|
| Rate for Payer: UHC Core |
$51.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.08
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
OP
|
$61.44
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$55.30 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$15.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.20
|
| Rate for Payer: BCBS Complete |
$11.37
|
| Rate for Payer: BCBS MAPPO |
$15.36
|
| Rate for Payer: BCBS Trust/PPO |
$50.51
|
| Rate for Payer: BCN Commercial |
$50.51
|
| Rate for Payer: BCN Medicare Advantage |
$15.36
|
| Rate for Payer: Cash Price |
$49.15
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.36
|
| Rate for Payer: Healthscope Commercial |
$55.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.08
|
| Rate for Payer: Mclaren Medicaid |
$10.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.13
|
| Rate for Payer: Meridian Medicaid |
$11.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.22
|
| Rate for Payer: Nomi Health Commercial |
$50.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.08
|
| Rate for Payer: PACE Senior Care Partners |
$14.59
|
| Rate for Payer: PACE SWMI |
$15.36
|
| Rate for Payer: PHP Commercial |
$52.22
|
| Rate for Payer: PHP Medicare Advantage |
$15.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.45
|
| Rate for Payer: Priority Health Medicare |
$15.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.07
|
| Rate for Payer: UHC Core |
$51.30
|
| Rate for Payer: UHC Exchange |
$15.36
|
| Rate for Payer: UHC Medicaid |
$10.83
|
| Rate for Payer: UHC Medicare Advantage |
$15.36
|
| Rate for Payer: UHCCP Medicaid |
$10.83
|
| Rate for Payer: VA VA |
$15.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.08
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
IP
|
$595.08
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$414.18 |
| Max. Negotiated Rate |
$535.57 |
| Rate for Payer: Aetna Commercial |
$505.82
|
| Rate for Payer: BCBS Trust/PPO |
$491.48
|
| Rate for Payer: BCN Commercial |
$491.48
|
| Rate for Payer: Cash Price |
$476.06
|
| Rate for Payer: Cofinity Commercial |
$511.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.06
|
| Rate for Payer: Healthscope Commercial |
$535.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.82
|
| Rate for Payer: Nomi Health Commercial |
$487.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.31
|
| Rate for Payer: PHP Commercial |
$505.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.67
|
| Rate for Payer: UHC Core |
$496.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.31
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
OP
|
$595.08
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$104.91 |
| Max. Negotiated Rate |
$535.57 |
| Rate for Payer: Aetna Commercial |
$505.82
|
| Rate for Payer: Aetna Medicare |
$154.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.96
|
| Rate for Payer: BCBS Complete |
$110.15
|
| Rate for Payer: BCBS MAPPO |
$148.77
|
| Rate for Payer: BCBS Trust/PPO |
$489.22
|
| Rate for Payer: BCN Commercial |
$489.22
|
| Rate for Payer: BCN Medicare Advantage |
$148.77
|
| Rate for Payer: Cash Price |
$476.06
|
| Rate for Payer: Cofinity Commercial |
$511.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.77
|
| Rate for Payer: Healthscope Commercial |
$535.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.31
|
| Rate for Payer: Mclaren Medicaid |
$104.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.21
|
| Rate for Payer: Meridian Medicaid |
$110.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.82
|
| Rate for Payer: Nomi Health Commercial |
$487.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.31
|
| Rate for Payer: PACE Senior Care Partners |
$141.33
|
| Rate for Payer: PACE SWMI |
$148.77
|
| Rate for Payer: PHP Commercial |
$505.82
|
| Rate for Payer: PHP Medicare Advantage |
$148.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.72
|
| Rate for Payer: Priority Health Medicare |
$150.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.18
|
| Rate for Payer: Railroad Medicare Medicare |
$148.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.67
|
| Rate for Payer: UHC Core |
$496.89
|
| Rate for Payer: UHC Exchange |
$148.77
|
| Rate for Payer: UHC Medicaid |
$104.91
|
| Rate for Payer: UHC Medicare Advantage |
$148.77
|
| Rate for Payer: UHCCP Medicaid |
$104.91
|
| Rate for Payer: VA VA |
$148.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.31
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
OP
|
$1,250.15
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$1,125.13 |
| Rate for Payer: Aetna Commercial |
$1,062.63
|
| Rate for Payer: Aetna Medicare |
$325.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$390.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$390.67
|
| Rate for Payer: BCBS Complete |
$231.40
|
| Rate for Payer: BCBS MAPPO |
$312.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,027.75
|
| Rate for Payer: BCN Commercial |
$1,027.75
|
| Rate for Payer: BCN Medicare Advantage |
$312.54
|
| Rate for Payer: Cash Price |
$1,000.12
|
| Rate for Payer: Cofinity Commercial |
$1,075.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.54
|
| Rate for Payer: Healthscope Commercial |
$1,125.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$937.61
|
| Rate for Payer: Mclaren Medicaid |
$220.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.16
|
| Rate for Payer: Meridian Medicaid |
$231.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$359.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,062.63
|
| Rate for Payer: Nomi Health Commercial |
$1,025.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.61
|
| Rate for Payer: PACE Senior Care Partners |
$296.91
|
| Rate for Payer: PACE SWMI |
$312.54
|
| Rate for Payer: PHP Commercial |
$1,062.63
|
| Rate for Payer: PHP Medicare Advantage |
$312.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,087.63
|
| Rate for Payer: Priority Health Medicare |
$315.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$870.10
|
| Rate for Payer: Railroad Medicare Medicare |
$312.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.13
|
| Rate for Payer: UHC Core |
$1,043.88
|
| Rate for Payer: UHC Exchange |
$312.54
|
| Rate for Payer: UHC Medicaid |
$220.40
|
| Rate for Payer: UHC Medicare Advantage |
$312.54
|
| Rate for Payer: UHCCP Medicaid |
$220.40
|
| Rate for Payer: VA VA |
$312.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$937.61
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
IP
|
$1,250.15
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$870.10 |
| Max. Negotiated Rate |
$1,125.13 |
| Rate for Payer: Aetna Commercial |
$1,062.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,032.50
|
| Rate for Payer: BCN Commercial |
$1,032.50
|
| Rate for Payer: Cash Price |
$1,000.12
|
| Rate for Payer: Cofinity Commercial |
$1,075.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.12
|
| Rate for Payer: Healthscope Commercial |
$1,125.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$937.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,062.63
|
| Rate for Payer: Nomi Health Commercial |
$1,025.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.61
|
| Rate for Payer: PHP Commercial |
$1,062.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,087.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$870.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.13
|
| Rate for Payer: UHC Core |
$1,043.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$937.61
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
OP
|
$87.29
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.39 |
| Max. Negotiated Rate |
$78.56 |
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna Medicare |
$22.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.28
|
| Rate for Payer: BCBS Complete |
$16.16
|
| Rate for Payer: BCBS MAPPO |
$21.82
|
| Rate for Payer: BCBS Trust/PPO |
$71.76
|
| Rate for Payer: BCN Commercial |
$71.76
|
| Rate for Payer: BCN Medicare Advantage |
$21.82
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.82
|
| Rate for Payer: Healthscope Commercial |
$78.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Mclaren Medicaid |
$15.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.91
|
| Rate for Payer: Meridian Medicaid |
$16.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PACE Senior Care Partners |
$20.73
|
| Rate for Payer: PACE SWMI |
$21.82
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.94
|
| Rate for Payer: Priority Health Medicare |
$22.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.75
|
| Rate for Payer: Railroad Medicare Medicare |
$21.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.82
|
| Rate for Payer: UHC Core |
$72.89
|
| Rate for Payer: UHC Exchange |
$21.82
|
| Rate for Payer: UHC Medicaid |
$15.39
|
| Rate for Payer: UHC Medicare Advantage |
$21.82
|
| Rate for Payer: UHCCP Medicaid |
$15.39
|
| Rate for Payer: VA VA |
$21.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
IP
|
$87.29
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$60.75 |
| Max. Negotiated Rate |
$78.56 |
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$72.09
|
| Rate for Payer: BCN Commercial |
$72.09
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Healthscope Commercial |
$78.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.82
|
| Rate for Payer: UHC Core |
$72.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
IP
|
$91.06
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.38 |
| Max. Negotiated Rate |
$81.95 |
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: BCBS Trust/PPO |
$75.21
|
| Rate for Payer: BCN Commercial |
$75.21
|
| Rate for Payer: Cash Price |
$72.85
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.85
|
| Rate for Payer: Healthscope Commercial |
$81.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.40
|
| Rate for Payer: Nomi Health Commercial |
$74.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.30
|
| Rate for Payer: PHP Commercial |
$77.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.13
|
| Rate for Payer: UHC Core |
$76.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.30
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
OP
|
$91.06
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.05 |
| Max. Negotiated Rate |
$81.95 |
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Aetna Medicare |
$23.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.46
|
| Rate for Payer: BCBS Complete |
$16.86
|
| Rate for Payer: BCBS MAPPO |
$22.77
|
| Rate for Payer: BCBS Trust/PPO |
$74.86
|
| Rate for Payer: BCN Commercial |
$74.86
|
| Rate for Payer: BCN Medicare Advantage |
$22.77
|
| Rate for Payer: Cash Price |
$72.85
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.77
|
| Rate for Payer: Healthscope Commercial |
$81.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.30
|
| Rate for Payer: Mclaren Medicaid |
$16.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.90
|
| Rate for Payer: Meridian Medicaid |
$16.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.40
|
| Rate for Payer: Nomi Health Commercial |
$74.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.30
|
| Rate for Payer: PACE Senior Care Partners |
$21.63
|
| Rate for Payer: PACE SWMI |
$22.77
|
| Rate for Payer: PHP Commercial |
$77.40
|
| Rate for Payer: PHP Medicare Advantage |
$22.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.22
|
| Rate for Payer: Priority Health Medicare |
$22.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.38
|
| Rate for Payer: Railroad Medicare Medicare |
$22.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.13
|
| Rate for Payer: UHC Core |
$76.04
|
| Rate for Payer: UHC Exchange |
$22.77
|
| Rate for Payer: UHC Medicaid |
$16.05
|
| Rate for Payer: UHC Medicare Advantage |
$22.77
|
| Rate for Payer: UHCCP Medicaid |
$16.05
|
| Rate for Payer: VA VA |
$22.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.30
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
OP
|
$146.06
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$25.75 |
| Max. Negotiated Rate |
$131.45 |
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Medicare |
$37.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.64
|
| Rate for Payer: BCBS Complete |
$27.04
|
| Rate for Payer: BCBS MAPPO |
$36.52
|
| Rate for Payer: BCBS Trust/PPO |
$120.08
|
| Rate for Payer: BCN Commercial |
$120.08
|
| Rate for Payer: BCN Medicare Advantage |
$36.52
|
| Rate for Payer: Cash Price |
$116.85
|
| Rate for Payer: Cofinity Commercial |
$125.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.52
|
| Rate for Payer: Healthscope Commercial |
$131.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.55
|
| Rate for Payer: Mclaren Medicaid |
$25.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.34
|
| Rate for Payer: Meridian Medicaid |
$27.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.15
|
| Rate for Payer: Nomi Health Commercial |
$119.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.55
|
| Rate for Payer: PACE Senior Care Partners |
$34.69
|
| Rate for Payer: PACE SWMI |
$36.52
|
| Rate for Payer: PHP Commercial |
$124.15
|
| Rate for Payer: PHP Medicare Advantage |
$36.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.07
|
| Rate for Payer: Priority Health Medicare |
$36.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.66
|
| Rate for Payer: Railroad Medicare Medicare |
$36.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.53
|
| Rate for Payer: UHC Core |
$121.96
|
| Rate for Payer: UHC Exchange |
$36.52
|
| Rate for Payer: UHC Medicaid |
$25.75
|
| Rate for Payer: UHC Medicare Advantage |
$36.52
|
| Rate for Payer: UHCCP Medicaid |
$25.75
|
| Rate for Payer: VA VA |
$36.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.55
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
IP
|
$146.06
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$101.66 |
| Max. Negotiated Rate |
$131.45 |
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: BCBS Trust/PPO |
$120.63
|
| Rate for Payer: BCN Commercial |
$120.63
|
| Rate for Payer: Cash Price |
$116.85
|
| Rate for Payer: Cofinity Commercial |
$125.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.85
|
| Rate for Payer: Healthscope Commercial |
$131.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.15
|
| Rate for Payer: Nomi Health Commercial |
$119.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.55
|
| Rate for Payer: PHP Commercial |
$124.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.53
|
| Rate for Payer: UHC Core |
$121.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.55
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
IP
|
$1,077.76
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$750.12 |
| Max. Negotiated Rate |
$969.98 |
| Rate for Payer: Aetna Commercial |
$916.10
|
| Rate for Payer: BCBS Trust/PPO |
$890.12
|
| Rate for Payer: BCN Commercial |
$890.12
|
| Rate for Payer: Cash Price |
$862.21
|
| Rate for Payer: Cofinity Commercial |
$926.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$862.21
|
| Rate for Payer: Healthscope Commercial |
$969.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$808.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$916.10
|
| Rate for Payer: Nomi Health Commercial |
$883.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.32
|
| Rate for Payer: PHP Commercial |
$916.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$937.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$750.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$948.43
|
| Rate for Payer: UHC Core |
$899.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$808.32
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
OP
|
$1,077.76
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$190.01 |
| Max. Negotiated Rate |
$969.98 |
| Rate for Payer: Aetna Commercial |
$916.10
|
| Rate for Payer: Aetna Medicare |
$280.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$336.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$336.80
|
| Rate for Payer: BCBS Complete |
$199.49
|
| Rate for Payer: BCBS MAPPO |
$269.44
|
| Rate for Payer: BCBS Trust/PPO |
$886.03
|
| Rate for Payer: BCN Commercial |
$886.03
|
| Rate for Payer: BCN Medicare Advantage |
$269.44
|
| Rate for Payer: Cash Price |
$862.21
|
| Rate for Payer: Cofinity Commercial |
$926.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$862.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.44
|
| Rate for Payer: Healthscope Commercial |
$969.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$808.32
|
| Rate for Payer: Mclaren Medicaid |
$190.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.91
|
| Rate for Payer: Meridian Medicaid |
$199.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$296.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$916.10
|
| Rate for Payer: Nomi Health Commercial |
$883.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.32
|
| Rate for Payer: PACE Senior Care Partners |
$255.97
|
| Rate for Payer: PACE SWMI |
$269.44
|
| Rate for Payer: PHP Commercial |
$916.10
|
| Rate for Payer: PHP Medicare Advantage |
$269.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$937.65
|
| Rate for Payer: Priority Health Medicare |
$272.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$750.12
|
| Rate for Payer: Railroad Medicare Medicare |
$269.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$948.43
|
| Rate for Payer: UHC Core |
$899.93
|
| Rate for Payer: UHC Exchange |
$269.44
|
| Rate for Payer: UHC Medicaid |
$190.01
|
| Rate for Payer: UHC Medicare Advantage |
$269.44
|
| Rate for Payer: UHCCP Medicaid |
$190.01
|
| Rate for Payer: VA VA |
$269.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$808.32
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
IP
|
$67.73
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.14 |
| Max. Negotiated Rate |
$60.96 |
| Rate for Payer: Aetna Commercial |
$57.57
|
| Rate for Payer: BCBS Trust/PPO |
$55.94
|
| Rate for Payer: BCN Commercial |
$55.94
|
| Rate for Payer: Cash Price |
$54.18
|
| Rate for Payer: Cofinity Commercial |
$58.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.18
|
| Rate for Payer: Healthscope Commercial |
$60.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.57
|
| Rate for Payer: Nomi Health Commercial |
$55.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.80
|
| Rate for Payer: PHP Commercial |
$57.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.60
|
| Rate for Payer: UHC Core |
$56.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.80
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
OP
|
$67.73
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.94 |
| Max. Negotiated Rate |
$60.96 |
| Rate for Payer: Aetna Commercial |
$57.57
|
| Rate for Payer: Aetna Medicare |
$17.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.17
|
| Rate for Payer: BCBS Complete |
$12.54
|
| Rate for Payer: BCBS MAPPO |
$16.93
|
| Rate for Payer: BCBS Trust/PPO |
$55.68
|
| Rate for Payer: BCN Commercial |
$55.68
|
| Rate for Payer: BCN Medicare Advantage |
$16.93
|
| Rate for Payer: Cash Price |
$54.18
|
| Rate for Payer: Cofinity Commercial |
$58.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.93
|
| Rate for Payer: Healthscope Commercial |
$60.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.80
|
| Rate for Payer: Mclaren Medicaid |
$11.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.78
|
| Rate for Payer: Meridian Medicaid |
$12.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.57
|
| Rate for Payer: Nomi Health Commercial |
$55.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.80
|
| Rate for Payer: PACE Senior Care Partners |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.93
|
| Rate for Payer: PHP Commercial |
$57.57
|
| Rate for Payer: PHP Medicare Advantage |
$16.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.93
|
| Rate for Payer: Priority Health Medicare |
$17.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.14
|
| Rate for Payer: Railroad Medicare Medicare |
$16.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.60
|
| Rate for Payer: UHC Core |
$56.55
|
| Rate for Payer: UHC Exchange |
$16.93
|
| Rate for Payer: UHC Medicaid |
$11.94
|
| Rate for Payer: UHC Medicare Advantage |
$16.93
|
| Rate for Payer: UHCCP Medicaid |
$11.94
|
| Rate for Payer: VA VA |
$16.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.80
|
|
|
HC THYROXINE FREE T4
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$30.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.74
|
| Rate for Payer: BCBS Complete |
$21.76
|
| Rate for Payer: BCBS MAPPO |
$29.39
|
| Rate for Payer: BCBS Trust/PPO |
$96.65
|
| Rate for Payer: BCN Commercial |
$96.65
|
| Rate for Payer: BCN Medicare Advantage |
$29.39
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.39
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$20.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.86
|
| Rate for Payer: Meridian Medicaid |
$21.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PACE Senior Care Partners |
$27.92
|
| Rate for Payer: PACE SWMI |
$29.39
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Medicare |
$29.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.83
|
| Rate for Payer: Railroad Medicare Medicare |
$29.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicaid |
$20.73
|
| Rate for Payer: UHC Medicare Advantage |
$29.39
|
| Rate for Payer: UHCCP Medicaid |
$20.73
|
| Rate for Payer: VA VA |
$29.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC THYROXINE FREE T4
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.83 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$97.10
|
| Rate for Payer: BCN Commercial |
$97.10
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
IP
|
$118.25
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.30 |
| Max. Negotiated Rate |
$106.42 |
| Rate for Payer: Aetna Commercial |
$100.51
|
| Rate for Payer: BCBS Trust/PPO |
$97.66
|
| Rate for Payer: BCN Commercial |
$97.66
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$101.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.60
|
| Rate for Payer: Healthscope Commercial |
$106.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.51
|
| Rate for Payer: Nomi Health Commercial |
$96.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.69
|
| Rate for Payer: PHP Commercial |
$100.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.06
|
| Rate for Payer: UHC Core |
$98.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.69
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
OP
|
$118.25
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.85 |
| Max. Negotiated Rate |
$106.42 |
| Rate for Payer: Aetna Commercial |
$100.51
|
| Rate for Payer: Aetna Medicare |
$30.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.95
|
| Rate for Payer: BCBS Complete |
$21.89
|
| Rate for Payer: BCBS MAPPO |
$29.56
|
| Rate for Payer: BCBS Trust/PPO |
$97.21
|
| Rate for Payer: BCN Commercial |
$97.21
|
| Rate for Payer: BCN Medicare Advantage |
$29.56
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$101.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.56
|
| Rate for Payer: Healthscope Commercial |
$106.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.69
|
| Rate for Payer: Mclaren Medicaid |
$20.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.04
|
| Rate for Payer: Meridian Medicaid |
$21.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.51
|
| Rate for Payer: Nomi Health Commercial |
$96.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.69
|
| Rate for Payer: PACE Senior Care Partners |
$28.08
|
| Rate for Payer: PACE SWMI |
$29.56
|
| Rate for Payer: PHP Commercial |
$100.51
|
| Rate for Payer: PHP Medicare Advantage |
$29.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.88
|
| Rate for Payer: Priority Health Medicare |
$29.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.30
|
| Rate for Payer: Railroad Medicare Medicare |
$29.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.06
|
| Rate for Payer: UHC Core |
$98.74
|
| Rate for Payer: UHC Exchange |
$29.56
|
| Rate for Payer: UHC Medicaid |
$20.85
|
| Rate for Payer: UHC Medicare Advantage |
$29.56
|
| Rate for Payer: UHCCP Medicaid |
$20.85
|
| Rate for Payer: VA VA |
$29.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.69
|
|
|
HC TICK-BORNE AB CMPT 2
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 86753
|
| Hospital Charge Code |
30200521
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$28.90
|
| Rate for Payer: BCBS Trust/PPO |
$28.08
|
| Rate for Payer: BCN Commercial |
$28.08
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$29.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.20
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.90
|
| Rate for Payer: Nomi Health Commercial |
$27.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PHP Commercial |
$28.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC Core |
$28.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.50
|
|
