|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$41.63
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$13.73
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$41.93
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$13.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$13.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Exchange |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.75
|
| Rate for Payer: UHCCP Medicaid |
$13.08
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC T3 FREE
|
Facility
|
IP
|
$132.19
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.92 |
| Max. Negotiated Rate |
$118.97 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: BCBS Trust/PPO |
$107.91
|
| Rate for Payer: BCN Commercial |
$102.16
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cofinity Commercial |
$113.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.75
|
| Rate for Payer: Healthscope Commercial |
$118.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.36
|
| Rate for Payer: Nomi Health Commercial |
$108.40
|
| Rate for Payer: PHP Commercial |
$112.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.92
|
| Rate for Payer: Priority Health HMO/PPO |
$115.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.33
|
| Rate for Payer: UHC Core |
$110.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.14
|
|
|
HC T3 FREE
|
Facility
|
OP
|
$132.19
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$118.97 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: Aetna Medicare |
$34.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.31
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$33.05
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$102.78
|
| Rate for Payer: BCN Medicare Advantage |
$33.05
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cofinity Commercial |
$113.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.05
|
| Rate for Payer: Healthscope Commercial |
$118.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.14
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.70
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.36
|
| Rate for Payer: Nomi Health Commercial |
$108.40
|
| Rate for Payer: PACE Senior Care Partners |
$31.40
|
| Rate for Payer: PACE SWMI |
$33.05
|
| Rate for Payer: PHP Commercial |
$112.36
|
| Rate for Payer: PHP Medicare Advantage |
$33.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.92
|
| Rate for Payer: Priority Health HMO/PPO |
$115.01
|
| Rate for Payer: Priority Health Medicare |
$33.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.57
|
| Rate for Payer: Railroad Medicare Medicare |
$33.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.33
|
| Rate for Payer: UHC Core |
$110.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.05
|
| Rate for Payer: UHC Exchange |
$33.05
|
| Rate for Payer: UHC Medicare Advantage |
$33.05
|
| Rate for Payer: UHCCP Medicaid |
$12.25
|
| Rate for Payer: VA VA |
$33.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.14
|
|
|
HC T3 REVERSE
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$11.96
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$45.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Mclaren Medicaid |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.26
|
| Rate for Payer: Meridian Medicaid |
$11.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Senior Care Partners |
$13.81
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Medicare |
$14.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: UHCCP Medicaid |
$11.39
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC T3 REVERSE
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$136.68
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$88.84 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: BCBS Trust/PPO |
$111.57
|
| Rate for Payer: BCN Commercial |
$105.63
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC T3 UPTAKE
|
Facility
|
OP
|
$136.68
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: Aetna Medicare |
$35.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.71
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$34.17
|
| Rate for Payer: BCBS Trust/PPO |
$112.36
|
| Rate for Payer: BCN Commercial |
$106.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.17
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.17
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.88
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PACE Senior Care Partners |
$32.46
|
| Rate for Payer: PACE SWMI |
$34.17
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: PHP Medicare Advantage |
$34.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Medicare |
$34.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: Railroad Medicare Medicare |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.17
|
| Rate for Payer: UHC Exchange |
$34.17
|
| Rate for Payer: UHC Medicare Advantage |
$34.17
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$34.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC T4 TOTAL
|
Facility
|
OP
|
$46.92
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: Aetna Medicare |
$12.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.66
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: BCBS MAPPO |
$11.73
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$36.48
|
| Rate for Payer: BCN Medicare Advantage |
$11.73
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.73
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.19
|
| Rate for Payer: Mclaren Medicaid |
$4.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.32
|
| Rate for Payer: Meridian Medicaid |
$5.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.88
|
| Rate for Payer: Nomi Health Commercial |
$38.47
|
| Rate for Payer: PACE Senior Care Partners |
$11.14
|
| Rate for Payer: PACE SWMI |
$11.73
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: PHP Medicare Advantage |
$11.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.50
|
| Rate for Payer: Priority Health HMO/PPO |
$40.82
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.44
|
| Rate for Payer: Railroad Medicare Medicare |
$11.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.29
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.73
|
| Rate for Payer: UHC Exchange |
$11.73
|
| Rate for Payer: UHC Medicare Advantage |
$11.73
|
| Rate for Payer: UHCCP Medicaid |
$4.97
|
| Rate for Payer: VA VA |
$11.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.19
|
|
|
HC T4 TOTAL
|
Facility
|
IP
|
$46.92
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.50 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: BCBS Trust/PPO |
$38.30
|
| Rate for Payer: BCN Commercial |
$36.26
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.88
|
| Rate for Payer: Nomi Health Commercial |
$38.47
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.50
|
| Rate for Payer: Priority Health HMO/PPO |
$40.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.29
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.19
|
|
|
HC T4 TOTAL ONLY
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100759
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$37.73
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$4.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$5.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Exchange |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.48
|
| Rate for Payer: UHCCP Medicaid |
$4.97
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC T4 TOTAL ONLY
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100759
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$37.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
OP
|
$65.55
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$55.72
|
| Rate for Payer: Aetna Medicare |
$17.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.48
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$16.39
|
| Rate for Payer: BCBS Trust/PPO |
$53.89
|
| Rate for Payer: BCN Commercial |
$50.97
|
| Rate for Payer: BCN Medicare Advantage |
$16.39
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$59.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.16
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.21
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.57
|
| Rate for Payer: PACE SWMI |
$16.39
|
| Rate for Payer: PHP Commercial |
$55.72
|
| Rate for Payer: PHP Medicare Advantage |
$16.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.61
|
| Rate for Payer: Priority Health HMO/PPO |
$57.03
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.92
|
| Rate for Payer: Railroad Medicare Medicare |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.68
|
| Rate for Payer: UHC Core |
$54.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.39
|
| Rate for Payer: UHC Exchange |
$16.39
|
| Rate for Payer: UHC Medicare Advantage |
$16.39
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.16
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
IP
|
$65.55
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$55.72
|
| Rate for Payer: BCBS Trust/PPO |
$53.51
|
| Rate for Payer: BCN Commercial |
$50.66
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Healthscope Commercial |
$59.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: PHP Commercial |
$55.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.61
|
| Rate for Payer: Priority Health HMO/PPO |
$57.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.68
|
| Rate for Payer: UHC Core |
$54.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.16
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.38
|
| Rate for Payer: BCN Commercial |
$47.70
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$28.64
|
| Rate for Payer: BCBS MAPPO |
$15.43
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: BCN Medicare Advantage |
$15.43
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.43
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$27.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.20
|
| Rate for Payer: Meridian Medicaid |
$28.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.43
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.43
|
| Rate for Payer: UHC Exchange |
$15.43
|
| Rate for Payer: UHC Medicare Advantage |
$15.43
|
| Rate for Payer: UHCCP Medicaid |
$27.28
|
| Rate for Payer: VA VA |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
IP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$69.17 |
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: BCBS Trust/PPO |
$62.74
|
| Rate for Payer: BCN Commercial |
$59.40
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Healthscope Commercial |
$69.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$63.03
|
| Rate for Payer: PHP Commercial |
$65.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health HMO/PPO |
$66.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.64
|
| Rate for Payer: UHC Core |
$64.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.64
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
OP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$69.17 |
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: Aetna Medicare |
$19.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.02
|
| Rate for Payer: BCBS Complete |
$35.67
|
| Rate for Payer: BCBS MAPPO |
$19.22
|
| Rate for Payer: BCBS Trust/PPO |
$63.19
|
| Rate for Payer: BCN Commercial |
$59.76
|
| Rate for Payer: BCN Medicare Advantage |
$19.22
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$69.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.64
|
| Rate for Payer: Mclaren Medicaid |
$33.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.18
|
| Rate for Payer: Meridian Medicaid |
$35.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$63.03
|
| Rate for Payer: PACE Senior Care Partners |
$18.25
|
| Rate for Payer: PACE SWMI |
$19.22
|
| Rate for Payer: PHP Commercial |
$65.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health HMO/PPO |
$66.87
|
| Rate for Payer: Priority Health Medicare |
$19.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.50
|
| Rate for Payer: Railroad Medicare Medicare |
$19.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.64
|
| Rate for Payer: UHC Core |
$64.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.22
|
| Rate for Payer: UHC Exchange |
$19.22
|
| Rate for Payer: UHC Medicare Advantage |
$19.22
|
| Rate for Payer: UHCCP Medicaid |
$33.97
|
| Rate for Payer: VA VA |
$19.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.64
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$28.64
|
| Rate for Payer: BCBS MAPPO |
$15.43
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: BCN Medicare Advantage |
$15.43
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.43
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$27.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.20
|
| Rate for Payer: Meridian Medicaid |
$28.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.43
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.43
|
| Rate for Payer: UHC Exchange |
$15.43
|
| Rate for Payer: UHC Medicare Advantage |
$15.43
|
| Rate for Payer: UHCCP Medicaid |
$27.28
|
| Rate for Payer: VA VA |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.38
|
| Rate for Payer: BCN Commercial |
$47.70
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.38
|
| Rate for Payer: BCN Commercial |
$47.70
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$28.64
|
| Rate for Payer: BCBS MAPPO |
$15.43
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: BCN Medicare Advantage |
$15.43
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.43
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$27.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.20
|
| Rate for Payer: Meridian Medicaid |
$28.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.43
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.43
|
| Rate for Payer: UHC Exchange |
$15.43
|
| Rate for Payer: UHC Medicare Advantage |
$15.43
|
| Rate for Payer: UHCCP Medicaid |
$27.28
|
| Rate for Payer: VA VA |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$20.33
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$24.66
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$19.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: Meridian Medicaid |
$20.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO |
$26.10
|
| Rate for Payer: Priority Health Medicare |
$7.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.50
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.50
|
| Rate for Payer: UHCCP Medicaid |
$19.36
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$24.49
|
| Rate for Payer: BCN Commercial |
$23.18
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO |
$26.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$83.55
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$75.20 |
| Rate for Payer: Aetna Commercial |
$71.02
|
| Rate for Payer: BCBS Trust/PPO |
$68.20
|
| Rate for Payer: BCN Commercial |
$64.57
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$71.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$75.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: PHP Commercial |
$71.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health HMO/PPO |
$72.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.52
|
| Rate for Payer: UHC Core |
$69.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.66
|
|
