|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,044.22 |
| Max. Negotiated Rate |
$1,445.85 |
| Rate for Payer: Aetna Commercial |
$1,365.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.39
|
| Rate for Payer: BCN Commercial |
$1,241.50
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,381.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Healthscope Commercial |
$1,445.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.53
|
| Rate for Payer: Nomi Health Commercial |
$1,317.33
|
| Rate for Payer: PHP Commercial |
$1,365.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,397.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,076.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.72
|
| Rate for Payer: UHC Core |
$1,341.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$283.67 |
| Max. Negotiated Rate |
$1,074.94 |
| Rate for Payer: Aetna Commercial |
$1,015.22
|
| Rate for Payer: Aetna Medicare |
$310.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$373.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$373.24
|
| Rate for Payer: BCBS Complete |
$477.75
|
| Rate for Payer: BCBS MAPPO |
$298.60
|
| Rate for Payer: BCBS Trust/PPO |
$981.90
|
| Rate for Payer: BCN Commercial |
$928.63
|
| Rate for Payer: BCN Medicare Advantage |
$298.60
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,027.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.60
|
| Rate for Payer: Healthscope Commercial |
$1,074.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$895.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: Nomi Health Commercial |
$979.39
|
| Rate for Payer: PACE Senior Care Partners |
$283.67
|
| Rate for Payer: PACE SWMI |
$298.60
|
| Rate for Payer: PHP Commercial |
$1,015.22
|
| Rate for Payer: PHP Medicare Advantage |
$298.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,039.11
|
| Rate for Payer: Priority Health Medicare |
$301.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.23
|
| Rate for Payer: Railroad Medicare Medicare |
$298.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.05
|
| Rate for Payer: UHC Core |
$997.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.60
|
| Rate for Payer: UHC Exchange |
$298.60
|
| Rate for Payer: UHC Medicare Advantage |
$298.60
|
| Rate for Payer: VA VA |
$298.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$895.78
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$776.35 |
| Max. Negotiated Rate |
$1,074.94 |
| Rate for Payer: Aetna Commercial |
$1,015.22
|
| Rate for Payer: BCBS Trust/PPO |
$974.97
|
| Rate for Payer: BCN Commercial |
$923.02
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,027.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Healthscope Commercial |
$1,074.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$895.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: Nomi Health Commercial |
$979.39
|
| Rate for Payer: PHP Commercial |
$1,015.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,039.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.05
|
| Rate for Payer: UHC Core |
$997.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$895.78
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,164.50 |
| Max. Negotiated Rate |
$4,412.83 |
| Rate for Payer: Aetna Commercial |
$4,167.67
|
| Rate for Payer: Aetna Medicare |
$1,274.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,532.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,532.23
|
| Rate for Payer: BCBS Complete |
$2,618.46
|
| Rate for Payer: BCBS MAPPO |
$1,225.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.87
|
| Rate for Payer: BCN Commercial |
$3,812.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,225.79
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,216.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,225.79
|
| Rate for Payer: Healthscope Commercial |
$4,412.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,677.36
|
| Rate for Payer: Mclaren Medicaid |
$2,493.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,287.07
|
| Rate for Payer: Meridian Medicaid |
$2,618.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,409.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$4,020.57
|
| Rate for Payer: PACE Senior Care Partners |
$1,164.50
|
| Rate for Payer: PACE SWMI |
$1,225.79
|
| Rate for Payer: PHP Commercial |
$4,167.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,225.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,493.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health HMO/PPO |
$4,265.73
|
| Rate for Payer: Priority Health Medicare |
$1,238.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,285.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,225.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,314.76
|
| Rate for Payer: UHC Core |
$4,094.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,225.79
|
| Rate for Payer: UHC Exchange |
$1,225.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,225.79
|
| Rate for Payer: UHCCP Medicaid |
$2,493.61
|
| Rate for Payer: VA VA |
$1,225.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,677.36
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,187.04 |
| Max. Negotiated Rate |
$4,412.83 |
| Rate for Payer: Aetna Commercial |
$4,167.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,002.43
|
| Rate for Payer: BCN Commercial |
$3,789.15
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,216.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Healthscope Commercial |
$4,412.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,677.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$4,020.57
|
| Rate for Payer: PHP Commercial |
$4,167.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health HMO/PPO |
$4,265.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,285.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,314.76
|
| Rate for Payer: UHC Core |
$4,094.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,677.36
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,758.15 |
| Max. Negotiated Rate |
$3,818.98 |
| Rate for Payer: Aetna Commercial |
$3,606.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,463.81
|
| Rate for Payer: BCN Commercial |
$3,279.23
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,649.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Healthscope Commercial |
$3,818.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,182.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,479.51
|
| Rate for Payer: PHP Commercial |
$3,606.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health HMO/PPO |
$3,691.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,843.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,734.11
|
| Rate for Payer: UHC Core |
$3,543.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,182.48
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,007.79 |
| Max. Negotiated Rate |
$3,818.98 |
| Rate for Payer: Aetna Commercial |
$3,606.81
|
| Rate for Payer: Aetna Medicare |
$1,103.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,326.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,326.03
|
| Rate for Payer: BCBS Complete |
$1,215.03
|
| Rate for Payer: BCBS MAPPO |
$1,060.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,488.43
|
| Rate for Payer: BCN Commercial |
$3,299.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,060.83
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,649.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,060.83
|
| Rate for Payer: Healthscope Commercial |
$3,818.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,182.48
|
| Rate for Payer: Mclaren Medicaid |
$1,157.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,113.87
|
| Rate for Payer: Meridian Medicaid |
$1,215.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,219.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,479.51
|
| Rate for Payer: PACE Senior Care Partners |
$1,007.79
|
| Rate for Payer: PACE SWMI |
$1,060.83
|
| Rate for Payer: PHP Commercial |
$3,606.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,060.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,157.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health HMO/PPO |
$3,691.68
|
| Rate for Payer: Priority Health Medicare |
$1,071.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,843.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,060.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,734.11
|
| Rate for Payer: UHC Core |
$3,543.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,060.83
|
| Rate for Payer: UHC Exchange |
$1,060.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,060.83
|
| Rate for Payer: UHCCP Medicaid |
$1,157.10
|
| Rate for Payer: VA VA |
$1,060.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,182.48
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$20.82
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$23.79 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$23.79
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$20.96
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$22.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$23.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.09
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Exchange |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$22.65
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.81 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna Medicare |
$6.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.65
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS MAPPO |
$6.12
|
| Rate for Payer: BCBS Trust/PPO |
$20.13
|
| Rate for Payer: BCN Commercial |
$19.03
|
| Rate for Payer: BCN Medicare Advantage |
$6.12
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$9.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.43
|
| Rate for Payer: Meridian Medicaid |
$10.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.81
|
| Rate for Payer: PACE SWMI |
$6.12
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: PHP Medicare Advantage |
$6.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO |
$21.30
|
| Rate for Payer: Priority Health Medicare |
$6.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.54
|
| Rate for Payer: UHC Core |
$20.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.12
|
| Rate for Payer: UHC Exchange |
$6.12
|
| Rate for Payer: UHC Medicare Advantage |
$6.12
|
| Rate for Payer: UHCCP Medicaid |
$9.57
|
| Rate for Payer: VA VA |
$6.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$19.98
|
| Rate for Payer: BCN Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO |
$21.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.54
|
| Rate for Payer: UHC Core |
$20.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.57 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$18.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.99
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS MAPPO |
$17.59
|
| Rate for Payer: BCBS Trust/PPO |
$57.86
|
| Rate for Payer: BCN Commercial |
$54.72
|
| Rate for Payer: BCN Medicare Advantage |
$17.59
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.59
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$9.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.47
|
| Rate for Payer: Meridian Medicaid |
$10.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PACE Senior Care Partners |
$16.72
|
| Rate for Payer: PACE SWMI |
$17.59
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$17.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: Railroad Medicare Medicare |
$17.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.59
|
| Rate for Payer: UHC Exchange |
$17.59
|
| Rate for Payer: UHC Medicare Advantage |
$17.59
|
| Rate for Payer: UHCCP Medicaid |
$9.57
|
| Rate for Payer: VA VA |
$17.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.45
|
| Rate for Payer: BCN Commercial |
$54.39
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$24.93 |
| Rate for Payer: Aetna Commercial |
$23.55
|
| Rate for Payer: Aetna Medicare |
$7.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.66
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS MAPPO |
$6.92
|
| Rate for Payer: BCBS Trust/PPO |
$22.77
|
| Rate for Payer: BCN Commercial |
$21.54
|
| Rate for Payer: BCN Medicare Advantage |
$6.92
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.92
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: PACE Senior Care Partners |
$6.58
|
| Rate for Payer: PACE SWMI |
$6.92
|
| Rate for Payer: PHP Commercial |
$23.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health HMO/PPO |
$24.10
|
| Rate for Payer: Priority Health Medicare |
$6.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.56
|
| Rate for Payer: Railroad Medicare Medicare |
$6.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.38
|
| Rate for Payer: UHC Core |
$23.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.92
|
| Rate for Payer: UHC Exchange |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$6.92
|
| Rate for Payer: VA VA |
$6.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.77
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$24.93 |
| Rate for Payer: Aetna Commercial |
$23.55
|
| Rate for Payer: BCBS Trust/PPO |
$22.61
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: PHP Commercial |
$23.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health HMO/PPO |
$24.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.38
|
| Rate for Payer: UHC Core |
$23.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.77
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
IP
|
$447.35
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.78 |
| Max. Negotiated Rate |
$402.62 |
| Rate for Payer: Aetna Commercial |
$380.25
|
| Rate for Payer: BCBS Trust/PPO |
$365.17
|
| Rate for Payer: BCN Commercial |
$345.71
|
| Rate for Payer: Cash Price |
$357.88
|
| Rate for Payer: Cofinity Commercial |
$384.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.88
|
| Rate for Payer: Healthscope Commercial |
$402.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.25
|
| Rate for Payer: Nomi Health Commercial |
$366.83
|
| Rate for Payer: PHP Commercial |
$380.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.78
|
| Rate for Payer: Priority Health HMO/PPO |
$389.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.67
|
| Rate for Payer: UHC Core |
$373.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.51
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
OP
|
$447.35
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$106.25 |
| Max. Negotiated Rate |
$402.62 |
| Rate for Payer: Aetna Commercial |
$380.25
|
| Rate for Payer: Aetna Medicare |
$116.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.80
|
| Rate for Payer: BCBS Complete |
$178.94
|
| Rate for Payer: BCBS MAPPO |
$111.84
|
| Rate for Payer: BCBS Trust/PPO |
$367.77
|
| Rate for Payer: BCN Commercial |
$347.81
|
| Rate for Payer: BCN Medicare Advantage |
$111.84
|
| Rate for Payer: Cash Price |
$357.88
|
| Rate for Payer: Cofinity Commercial |
$384.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.84
|
| Rate for Payer: Healthscope Commercial |
$402.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.25
|
| Rate for Payer: Nomi Health Commercial |
$366.83
|
| Rate for Payer: PACE Senior Care Partners |
$106.25
|
| Rate for Payer: PACE SWMI |
$111.84
|
| Rate for Payer: PHP Commercial |
$380.25
|
| Rate for Payer: PHP Medicare Advantage |
$111.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.78
|
| Rate for Payer: Priority Health HMO/PPO |
$389.19
|
| Rate for Payer: Priority Health Medicare |
$112.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.72
|
| Rate for Payer: Railroad Medicare Medicare |
$111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.67
|
| Rate for Payer: UHC Core |
$373.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.84
|
| Rate for Payer: UHC Exchange |
$111.84
|
| Rate for Payer: UHC Medicare Advantage |
$111.84
|
| Rate for Payer: VA VA |
$111.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.51
|
|
|
HC TRIGLYCERIDES
|
Facility
|
IP
|
$21.66
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.08 |
| Max. Negotiated Rate |
$19.49 |
| Rate for Payer: Aetna Commercial |
$18.41
|
| Rate for Payer: BCBS Trust/PPO |
$17.68
|
| Rate for Payer: BCN Commercial |
$16.74
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.33
|
| Rate for Payer: Healthscope Commercial |
$19.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.41
|
| Rate for Payer: Nomi Health Commercial |
$17.76
|
| Rate for Payer: PHP Commercial |
$18.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.08
|
| Rate for Payer: Priority Health HMO/PPO |
$18.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.06
|
| Rate for Payer: UHC Core |
$18.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
HC TRIGLYCERIDES
|
Facility
|
OP
|
$21.66
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$19.49 |
| Rate for Payer: Aetna Commercial |
$18.41
|
| Rate for Payer: Aetna Medicare |
$5.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.77
|
| Rate for Payer: BCBS Complete |
$4.36
|
| Rate for Payer: BCBS MAPPO |
$5.42
|
| Rate for Payer: BCBS Trust/PPO |
$17.81
|
| Rate for Payer: BCN Commercial |
$16.84
|
| Rate for Payer: BCN Medicare Advantage |
$5.42
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.42
|
| Rate for Payer: Healthscope Commercial |
$19.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Mclaren Medicaid |
$4.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.69
|
| Rate for Payer: Meridian Medicaid |
$4.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.41
|
| Rate for Payer: Nomi Health Commercial |
$17.76
|
| Rate for Payer: PACE Senior Care Partners |
$5.14
|
| Rate for Payer: PACE SWMI |
$5.42
|
| Rate for Payer: PHP Commercial |
$18.41
|
| Rate for Payer: PHP Medicare Advantage |
$5.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.08
|
| Rate for Payer: Priority Health HMO/PPO |
$18.84
|
| Rate for Payer: Priority Health Medicare |
$5.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.51
|
| Rate for Payer: Railroad Medicare Medicare |
$5.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.06
|
| Rate for Payer: UHC Core |
$18.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.42
|
| Rate for Payer: UHC Exchange |
$5.42
|
| Rate for Payer: UHC Medicare Advantage |
$5.42
|
| Rate for Payer: UHCCP Medicaid |
$4.15
|
| Rate for Payer: VA VA |
$5.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
HC TRIGLYCERIDES LMPP
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100689
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.88
|
| Rate for Payer: BCBS Complete |
$4.36
|
| Rate for Payer: BCBS MAPPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.83
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.90
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.90
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$4.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.10
|
| Rate for Payer: Meridian Medicaid |
$4.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$3.71
|
| Rate for Payer: PACE SWMI |
$3.90
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.90
|
| Rate for Payer: UHC Exchange |
$3.90
|
| Rate for Payer: UHC Medicare Advantage |
$3.90
|
| Rate for Payer: UHCCP Medicaid |
$4.15
|
| Rate for Payer: VA VA |
$3.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC TRIGLYCERIDES LMPP
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100689
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Commercial |
$12.06
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
