|
HC UREAPLASMA PCR CMPT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600302
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
OP
|
$363.86
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.15 |
| Max. Negotiated Rate |
$327.47 |
| Rate for Payer: Aetna Commercial |
$309.28
|
| Rate for Payer: Aetna Medicare |
$94.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.71
|
| Rate for Payer: BCBS Complete |
$67.35
|
| Rate for Payer: BCBS MAPPO |
$90.97
|
| Rate for Payer: BCBS Trust/PPO |
$299.13
|
| Rate for Payer: BCN Commercial |
$299.13
|
| Rate for Payer: BCN Medicare Advantage |
$90.97
|
| Rate for Payer: Cash Price |
$291.09
|
| Rate for Payer: Cofinity Commercial |
$312.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.97
|
| Rate for Payer: Healthscope Commercial |
$327.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.89
|
| Rate for Payer: Mclaren Medicaid |
$64.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.51
|
| Rate for Payer: Meridian Medicaid |
$67.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.28
|
| Rate for Payer: Nomi Health Commercial |
$298.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.89
|
| Rate for Payer: PACE Senior Care Partners |
$86.42
|
| Rate for Payer: PACE SWMI |
$90.97
|
| Rate for Payer: PHP Commercial |
$309.28
|
| Rate for Payer: PHP Medicare Advantage |
$90.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.56
|
| Rate for Payer: Priority Health Medicare |
$91.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.25
|
| Rate for Payer: Railroad Medicare Medicare |
$90.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.20
|
| Rate for Payer: UHC Core |
$303.82
|
| Rate for Payer: UHC Exchange |
$90.97
|
| Rate for Payer: UHC Medicaid |
$64.15
|
| Rate for Payer: UHC Medicare Advantage |
$90.97
|
| Rate for Payer: UHCCP Medicaid |
$64.15
|
| Rate for Payer: VA VA |
$90.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.89
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
IP
|
$363.86
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.25 |
| Max. Negotiated Rate |
$327.47 |
| Rate for Payer: Aetna Commercial |
$309.28
|
| Rate for Payer: BCBS Trust/PPO |
$300.51
|
| Rate for Payer: BCN Commercial |
$300.51
|
| Rate for Payer: Cash Price |
$291.09
|
| Rate for Payer: Cofinity Commercial |
$312.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.09
|
| Rate for Payer: Healthscope Commercial |
$327.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.28
|
| Rate for Payer: Nomi Health Commercial |
$298.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.89
|
| Rate for Payer: PHP Commercial |
$309.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.20
|
| Rate for Payer: UHC Core |
$303.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.89
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$32.57
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$10.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.32
|
| Rate for Payer: BCBS Complete |
$7.30
|
| Rate for Payer: BCBS MAPPO |
$9.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: BCN Medicare Advantage |
$9.86
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.86
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$6.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.35
|
| Rate for Payer: Meridian Medicaid |
$7.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Senior Care Partners |
$9.36
|
| Rate for Payer: PACE SWMI |
$9.86
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Medicare |
$9.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: UHC Exchange |
$9.86
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHC Medicare Advantage |
$9.86
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: VA VA |
$9.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URIC ACID SERUM
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URIC ACID SERUM
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URINALYSIS
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URINALYSIS
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$10.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.32
|
| Rate for Payer: BCBS Complete |
$7.30
|
| Rate for Payer: BCBS MAPPO |
$9.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: BCN Medicare Advantage |
$9.86
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.86
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$6.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.35
|
| Rate for Payer: Meridian Medicaid |
$7.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Senior Care Partners |
$9.36
|
| Rate for Payer: PACE SWMI |
$9.86
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Medicare |
$9.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: UHC Exchange |
$9.86
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHC Medicare Advantage |
$9.86
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: VA VA |
$9.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$32.57
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
OP
|
$14.34
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$12.91 |
| Rate for Payer: Aetna Commercial |
$12.19
|
| Rate for Payer: Aetna Medicare |
$3.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.48
|
| Rate for Payer: BCBS Complete |
$2.65
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.79
|
| Rate for Payer: BCN Commercial |
$11.79
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$11.47
|
| Rate for Payer: Cofinity Commercial |
$12.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$12.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.76
|
| Rate for Payer: Mclaren Medicaid |
$2.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: Meridian Medicaid |
$2.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.19
|
| Rate for Payer: Nomi Health Commercial |
$11.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.76
|
| Rate for Payer: PACE Senior Care Partners |
$3.41
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$12.19
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.48
|
| Rate for Payer: Priority Health Medicare |
$3.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.62
|
| Rate for Payer: UHC Core |
$11.97
|
| Rate for Payer: UHC Exchange |
$3.58
|
| Rate for Payer: UHC Medicaid |
$2.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.58
|
| Rate for Payer: UHCCP Medicaid |
$2.53
|
| Rate for Payer: VA VA |
$3.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.76
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
IP
|
$14.34
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$12.91 |
| Rate for Payer: Aetna Commercial |
$12.19
|
| Rate for Payer: BCBS Trust/PPO |
$11.84
|
| Rate for Payer: BCN Commercial |
$11.84
|
| Rate for Payer: Cash Price |
$11.47
|
| Rate for Payer: Cofinity Commercial |
$12.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.47
|
| Rate for Payer: Healthscope Commercial |
$12.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.19
|
| Rate for Payer: Nomi Health Commercial |
$11.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.76
|
| Rate for Payer: PHP Commercial |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.62
|
| Rate for Payer: UHC Core |
$11.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.76
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.11 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: BCBS Trust/PPO |
$79.63
|
| Rate for Payer: BCN Commercial |
$79.63
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$25.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.13
|
| Rate for Payer: BCBS Complete |
$17.85
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.31
|
| Rate for Payer: Meridian Medicaid |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Senior Care Partners |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Medicare |
$24.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$17.00
|
| Rate for Payer: VA VA |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.08
|
| Rate for Payer: BCBS Complete |
$5.97
|
| Rate for Payer: BCBS MAPPO |
$8.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: BCN Medicare Advantage |
$8.06
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.06
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Mclaren Medicaid |
$5.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Meridian Medicaid |
$5.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PACE Senior Care Partners |
$7.66
|
| Rate for Payer: PACE SWMI |
$8.06
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$8.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Medicare |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.45
|
| Rate for Payer: Railroad Medicare Medicare |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: UHC Exchange |
$8.06
|
| Rate for Payer: UHC Medicaid |
$5.69
|
| Rate for Payer: UHC Medicare Advantage |
$8.06
|
| Rate for Payer: UHCCP Medicaid |
$5.69
|
| Rate for Payer: VA VA |
$8.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: BCBS Trust/PPO |
$26.64
|
| Rate for Payer: BCN Commercial |
$26.64
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC URINE CULTURE
|
Facility
|
IP
|
$40.88
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.45 |
| Max. Negotiated Rate |
$36.79 |
| Rate for Payer: Aetna Commercial |
$34.75
|
| Rate for Payer: BCBS Trust/PPO |
$33.76
|
| Rate for Payer: BCN Commercial |
$33.76
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cofinity Commercial |
$35.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.70
|
| Rate for Payer: Healthscope Commercial |
$36.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.75
|
| Rate for Payer: Nomi Health Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.66
|
| Rate for Payer: PHP Commercial |
$34.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.97
|
| Rate for Payer: UHC Core |
$34.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.66
|
|
|
HC URINE CULTURE
|
Facility
|
OP
|
$40.88
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$36.79 |
| Rate for Payer: Aetna Commercial |
$34.75
|
| Rate for Payer: Aetna Medicare |
$10.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.78
|
| Rate for Payer: BCBS Complete |
$7.57
|
| Rate for Payer: BCBS MAPPO |
$10.22
|
| Rate for Payer: BCBS Trust/PPO |
$33.61
|
| Rate for Payer: BCN Commercial |
$33.61
|
| Rate for Payer: BCN Medicare Advantage |
$10.22
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cofinity Commercial |
$35.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.22
|
| Rate for Payer: Healthscope Commercial |
$36.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.66
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.73
|
| Rate for Payer: Meridian Medicaid |
$7.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.75
|
| Rate for Payer: Nomi Health Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.66
|
| Rate for Payer: PACE Senior Care Partners |
$9.71
|
| Rate for Payer: PACE SWMI |
$10.22
|
| Rate for Payer: PHP Commercial |
$34.75
|
| Rate for Payer: PHP Medicare Advantage |
$10.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.57
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.45
|
| Rate for Payer: Railroad Medicare Medicare |
$10.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.97
|
| Rate for Payer: UHC Core |
$34.13
|
| Rate for Payer: UHC Exchange |
$10.22
|
| Rate for Payer: UHC Medicaid |
$7.21
|
| Rate for Payer: UHC Medicare Advantage |
$10.22
|
| Rate for Payer: UHCCP Medicaid |
$7.21
|
| Rate for Payer: VA VA |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.66
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
OP
|
$25.78
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$23.20 |
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: Aetna Medicare |
$6.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.06
|
| Rate for Payer: BCBS Complete |
$4.77
|
| Rate for Payer: BCBS MAPPO |
$6.45
|
| Rate for Payer: BCBS Trust/PPO |
$21.19
|
| Rate for Payer: BCN Commercial |
$21.19
|
| Rate for Payer: BCN Medicare Advantage |
$6.45
|
| Rate for Payer: Cash Price |
$20.62
|
| Rate for Payer: Cofinity Commercial |
$22.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.45
|
| Rate for Payer: Healthscope Commercial |
$23.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Mclaren Medicaid |
$4.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.77
|
| Rate for Payer: Meridian Medicaid |
$4.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.91
|
| Rate for Payer: Nomi Health Commercial |
$21.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PACE Senior Care Partners |
$6.12
|
| Rate for Payer: PACE SWMI |
$6.45
|
| Rate for Payer: PHP Commercial |
$21.91
|
| Rate for Payer: PHP Medicare Advantage |
$6.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.43
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.94
|
| Rate for Payer: Railroad Medicare Medicare |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.69
|
| Rate for Payer: UHC Core |
$21.53
|
| Rate for Payer: UHC Exchange |
$6.45
|
| Rate for Payer: UHC Medicaid |
$4.55
|
| Rate for Payer: UHC Medicare Advantage |
$6.45
|
| Rate for Payer: UHCCP Medicaid |
$4.55
|
| Rate for Payer: VA VA |
$6.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
IP
|
$25.78
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.94 |
| Max. Negotiated Rate |
$23.20 |
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: Cash Price |
$20.62
|
| Rate for Payer: Cofinity Commercial |
$22.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.62
|
| Rate for Payer: Healthscope Commercial |
$23.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.91
|
| Rate for Payer: Nomi Health Commercial |
$21.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PHP Commercial |
$21.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.69
|
| Rate for Payer: UHC Core |
$21.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.89 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: BCBS Trust/PPO |
$53.27
|
| Rate for Payer: BCN Commercial |
$53.27
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.16
|
| Rate for Payer: BCBS Complete |
$11.94
|
| Rate for Payer: BCBS MAPPO |
$16.12
|
| Rate for Payer: BCBS Trust/PPO |
$53.03
|
| Rate for Payer: BCN Commercial |
$53.03
|
| Rate for Payer: BCN Medicare Advantage |
$16.12
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Mclaren Medicaid |
$11.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PACE Senior Care Partners |
$15.32
|
| Rate for Payer: PACE SWMI |
$16.12
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Medicare |
$16.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: Railroad Medicare Medicare |
$16.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: UHC Exchange |
$16.12
|
| Rate for Payer: UHC Medicaid |
$11.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.12
|
| Rate for Payer: UHCCP Medicaid |
$11.37
|
| Rate for Payer: VA VA |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
