|
HC TORCH PROFILE IGM CMPT 1
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200280
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$17.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.46
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$17.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$53.39
|
| Rate for Payer: BCN Medicare Advantage |
$17.17
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.17
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.03
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PACE Senior Care Partners |
$16.31
|
| Rate for Payer: PACE SWMI |
$17.17
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.17
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UHC Medicare Advantage |
$17.17
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$17.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC TORCH PROFILE IGM CMPT 1
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200280
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.06
|
| Rate for Payer: BCN Commercial |
$53.07
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC TORCH PROFILE IGM CMPT 2
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200324
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$17.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.46
|
| Rate for Payer: BCBS Complete |
$10.94
|
| Rate for Payer: BCBS MAPPO |
$17.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$53.39
|
| Rate for Payer: BCN Medicare Advantage |
$17.17
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.17
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$10.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.03
|
| Rate for Payer: Meridian Medicaid |
$10.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PACE Senior Care Partners |
$16.31
|
| Rate for Payer: PACE SWMI |
$17.17
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.17
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UHC Medicare Advantage |
$17.17
|
| Rate for Payer: UHCCP Medicaid |
$10.42
|
| Rate for Payer: VA VA |
$17.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC TORCH PROFILE IGM CMPT 2
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200324
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.06
|
| Rate for Payer: BCN Commercial |
$53.07
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC TOTAL BODY TUMOR SCAN 2 OR MORE DAYS
|
Facility
|
IP
|
$2,333.11
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
34100057
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,516.52 |
| Max. Negotiated Rate |
$2,099.80 |
| Rate for Payer: Aetna Commercial |
$1,983.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.52
|
| Rate for Payer: BCN Commercial |
$1,803.03
|
| Rate for Payer: Cash Price |
$1,866.49
|
| Rate for Payer: Cofinity Commercial |
$2,006.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.49
|
| Rate for Payer: Healthscope Commercial |
$2,099.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.14
|
| Rate for Payer: Nomi Health Commercial |
$1,913.15
|
| Rate for Payer: PHP Commercial |
$1,983.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.52
|
| Rate for Payer: Priority Health HMO/PPO |
$2,029.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.14
|
| Rate for Payer: UHC Core |
$1,948.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.83
|
|
|
HC TOTAL BODY TUMOR SCAN 2 OR MORE DAYS
|
Facility
|
OP
|
$2,333.11
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
34100057
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$554.11 |
| Max. Negotiated Rate |
$2,099.80 |
| Rate for Payer: Aetna Commercial |
$1,983.14
|
| Rate for Payer: Aetna Medicare |
$606.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$729.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$729.10
|
| Rate for Payer: BCBS Complete |
$991.12
|
| Rate for Payer: BCBS MAPPO |
$583.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.05
|
| Rate for Payer: BCN Commercial |
$1,813.99
|
| Rate for Payer: BCN Medicare Advantage |
$583.28
|
| Rate for Payer: Cash Price |
$1,866.49
|
| Rate for Payer: Cash Price |
$1,866.49
|
| Rate for Payer: Cofinity Commercial |
$2,006.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.28
|
| Rate for Payer: Healthscope Commercial |
$2,099.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.83
|
| Rate for Payer: Mclaren Medicaid |
$943.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.44
|
| Rate for Payer: Meridian Medicaid |
$991.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$670.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.14
|
| Rate for Payer: Nomi Health Commercial |
$1,913.15
|
| Rate for Payer: PACE Senior Care Partners |
$554.11
|
| Rate for Payer: PACE SWMI |
$583.28
|
| Rate for Payer: PHP Commercial |
$1,983.14
|
| Rate for Payer: PHP Medicare Advantage |
$583.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$943.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.52
|
| Rate for Payer: Priority Health HMO/PPO |
$2,029.81
|
| Rate for Payer: Priority Health Medicare |
$589.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.18
|
| Rate for Payer: Railroad Medicare Medicare |
$583.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.14
|
| Rate for Payer: UHC Core |
$1,948.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$583.28
|
| Rate for Payer: UHC Exchange |
$583.28
|
| Rate for Payer: UHC Medicare Advantage |
$583.28
|
| Rate for Payer: UHCCP Medicaid |
$943.86
|
| Rate for Payer: VA VA |
$583.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.83
|
|
|
HC TOTAL IRON BIND CALC & TRANSFE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.23
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC TOTAL IRON BIND CALC & TRANSFE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC TOTAL PROTEIN
|
Facility
|
OP
|
$38.86
|
|
|
Service Code
|
CPT 84155
|
| Hospital Charge Code |
30100406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna Commercial |
$33.03
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.14
|
| Rate for Payer: BCBS Complete |
$2.79
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.21
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$33.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Mclaren Medicaid |
$2.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Meridian Medicaid |
$2.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE Senior Care Partners |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PHP Commercial |
$33.03
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: Railroad Medicare Medicare |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.20
|
| Rate for Payer: UHC Core |
$32.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.71
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Medicare Advantage |
$9.71
|
| Rate for Payer: UHCCP Medicaid |
$2.65
|
| Rate for Payer: VA VA |
$9.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC TOTAL PROTEIN
|
Facility
|
IP
|
$38.86
|
|
|
Service Code
|
CPT 84155
|
| Hospital Charge Code |
30100406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna Commercial |
$33.03
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$30.03
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$33.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PHP Commercial |
$33.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO |
$33.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.20
|
| Rate for Payer: UHC Core |
$32.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
IP
|
$38.86
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna Commercial |
$33.03
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$30.03
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$33.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PHP Commercial |
$33.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO |
$33.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.20
|
| Rate for Payer: UHC Core |
$32.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
OP
|
$38.86
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna Commercial |
$33.03
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.14
|
| Rate for Payer: BCBS Complete |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.21
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$33.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Mclaren Medicaid |
$2.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Meridian Medicaid |
$3.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE Senior Care Partners |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PHP Commercial |
$33.03
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: Railroad Medicare Medicare |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.20
|
| Rate for Payer: UHC Core |
$32.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.71
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Medicare Advantage |
$9.71
|
| Rate for Payer: UHCCP Medicaid |
$2.89
|
| Rate for Payer: VA VA |
$9.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC TOTAL PROTEIN URINE
|
Facility
|
OP
|
$38.86
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna Commercial |
$33.03
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.14
|
| Rate for Payer: BCBS Complete |
$2.79
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.21
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$33.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Mclaren Medicaid |
$2.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Meridian Medicaid |
$2.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE Senior Care Partners |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PHP Commercial |
$33.03
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: Railroad Medicare Medicare |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.20
|
| Rate for Payer: UHC Core |
$32.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.71
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Medicare Advantage |
$9.71
|
| Rate for Payer: UHCCP Medicaid |
$2.65
|
| Rate for Payer: VA VA |
$9.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC TOTAL PROTEIN URINE
|
Facility
|
IP
|
$38.86
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna Commercial |
$33.03
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$30.03
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$33.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PHP Commercial |
$33.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO |
$33.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.20
|
| Rate for Payer: UHC Core |
$32.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC TOTAL T3
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$10.77
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$37.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$10.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$10.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.04
|
| Rate for Payer: Priority Health HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.00
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.94
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$10.25
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TOTAL T3
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$38.99
|
| Rate for Payer: BCN Commercial |
$36.91
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.04
|
| Rate for Payer: Priority Health HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: BCBS Trust/PPO |
$135.88
|
| Rate for Payer: BCN Commercial |
$128.64
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.02
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.85
|
| Rate for Payer: BCN Commercial |
$129.42
|
| Rate for Payer: BCN Medicare Advantage |
$41.62
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.70
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: PACE Senior Care Partners |
$39.53
|
| Rate for Payer: PACE SWMI |
$41.62
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$41.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Medicare |
$42.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: Railroad Medicare Medicare |
$41.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.62
|
| Rate for Payer: UHC Exchange |
$41.62
|
| Rate for Payer: UHC Medicare Advantage |
$41.62
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: BCBS Trust/PPO |
$94.09
|
| Rate for Payer: BCN Commercial |
$89.07
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO |
$100.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$94.76
|
| Rate for Payer: BCN Commercial |
$89.61
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: PACE Senior Care Partners |
$27.37
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO |
$100.28
|
| Rate for Payer: Priority Health Medicare |
$29.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.22
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.82
|
| Rate for Payer: UHC Exchange |
$28.82
|
| Rate for Payer: UHC Medicare Advantage |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.94
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$10.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$10.42
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.75 |
| Max. Negotiated Rate |
$476.52 |
| Rate for Payer: Aetna Commercial |
$450.05
|
| Rate for Payer: Aetna Medicare |
$137.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.46
|
| Rate for Payer: BCBS Complete |
$353.92
|
| Rate for Payer: BCBS MAPPO |
$132.37
|
| Rate for Payer: BCBS Trust/PPO |
$435.28
|
| Rate for Payer: BCN Commercial |
$411.66
|
| Rate for Payer: BCN Medicare Advantage |
$132.37
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$455.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.37
|
| Rate for Payer: Healthscope Commercial |
$476.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.10
|
| Rate for Payer: Mclaren Medicaid |
$337.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.99
|
| Rate for Payer: Meridian Medicaid |
$353.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$434.17
|
| Rate for Payer: PACE Senior Care Partners |
$125.75
|
| Rate for Payer: PACE SWMI |
$132.37
|
| Rate for Payer: PHP Commercial |
$450.05
|
| Rate for Payer: PHP Medicare Advantage |
$132.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: Priority Health HMO/PPO |
$460.64
|
| Rate for Payer: Priority Health Medicare |
$133.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.74
|
| Rate for Payer: Railroad Medicare Medicare |
$132.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.93
|
| Rate for Payer: UHC Core |
$442.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.37
|
| Rate for Payer: UHC Exchange |
$132.37
|
| Rate for Payer: UHC Medicare Advantage |
$132.37
|
| Rate for Payer: UHCCP Medicaid |
$337.04
|
| Rate for Payer: VA VA |
$132.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.10
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$344.16 |
| Max. Negotiated Rate |
$476.52 |
| Rate for Payer: Aetna Commercial |
$450.05
|
| Rate for Payer: BCBS Trust/PPO |
$432.21
|
| Rate for Payer: BCN Commercial |
$409.17
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$455.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Healthscope Commercial |
$476.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$434.17
|
| Rate for Payer: PHP Commercial |
$450.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: Priority Health HMO/PPO |
$460.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.93
|
| Rate for Payer: UHC Core |
$442.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.10
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.09 |
| Max. Negotiated Rate |
$269.39 |
| Rate for Payer: Aetna Commercial |
$254.42
|
| Rate for Payer: Aetna Medicare |
$77.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.54
|
| Rate for Payer: BCBS Complete |
$119.73
|
| Rate for Payer: BCBS MAPPO |
$74.83
|
| Rate for Payer: BCBS Trust/PPO |
$246.07
|
| Rate for Payer: BCN Commercial |
$232.72
|
| Rate for Payer: BCN Medicare Advantage |
$74.83
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$257.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.83
|
| Rate for Payer: Healthscope Commercial |
$269.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: Nomi Health Commercial |
$245.44
|
| Rate for Payer: PACE Senior Care Partners |
$71.09
|
| Rate for Payer: PACE SWMI |
$74.83
|
| Rate for Payer: PHP Commercial |
$254.42
|
| Rate for Payer: PHP Medicare Advantage |
$74.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: Priority Health HMO/PPO |
$260.41
|
| Rate for Payer: Priority Health Medicare |
$75.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.54
|
| Rate for Payer: Railroad Medicare Medicare |
$74.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.40
|
| Rate for Payer: UHC Core |
$249.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.83
|
| Rate for Payer: UHC Exchange |
$74.83
|
| Rate for Payer: UHC Medicare Advantage |
$74.83
|
| Rate for Payer: VA VA |
$74.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.49
|
|
