|
HC URIC ACID SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$3.43
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$3.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$3.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$3.27
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC URINALYSIS
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC URINALYSIS
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$2.32
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$2.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$2.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$2.21
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
OP
|
$14.06
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.34 |
| Max. Negotiated Rate |
$12.65 |
| Rate for Payer: Aetna Commercial |
$11.95
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.39
|
| Rate for Payer: BCBS Complete |
$5.62
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS Trust/PPO |
$11.56
|
| Rate for Payer: BCN Commercial |
$10.93
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$12.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Healthscope Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.95
|
| Rate for Payer: Nomi Health Commercial |
$11.53
|
| Rate for Payer: PACE Senior Care Partners |
$3.34
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PHP Commercial |
$11.95
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.14
|
| Rate for Payer: Priority Health HMO/PPO |
$12.23
|
| Rate for Payer: Priority Health Medicare |
$3.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.37
|
| Rate for Payer: UHC Core |
$11.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Exchange |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.54
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
IP
|
$14.06
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$12.65 |
| Rate for Payer: Aetna Commercial |
$11.95
|
| Rate for Payer: BCBS Trust/PPO |
$11.48
|
| Rate for Payer: BCN Commercial |
$10.87
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$12.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.25
|
| Rate for Payer: Healthscope Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.95
|
| Rate for Payer: Nomi Health Commercial |
$11.53
|
| Rate for Payer: PHP Commercial |
$11.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.14
|
| Rate for Payer: Priority Health HMO/PPO |
$12.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.37
|
| Rate for Payer: UHC Core |
$11.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.54
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$23.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$73.50
|
| Rate for Payer: BCN Medicare Advantage |
$23.63
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.63
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.81
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.45
|
| Rate for Payer: PACE SWMI |
$23.63
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Medicare |
$23.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.63
|
| Rate for Payer: UHC Exchange |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$23.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.16
|
| Rate for Payer: BCN Commercial |
$73.05
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: BCBS MAPPO |
$7.91
|
| Rate for Payer: BCBS Trust/PPO |
$25.99
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.91
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.91
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: PACE Senior Care Partners |
$7.51
|
| Rate for Payer: PACE SWMI |
$7.91
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO |
$27.51
|
| Rate for Payer: Priority Health Medicare |
$7.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.19
|
| Rate for Payer: Railroad Medicare Medicare |
$7.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.91
|
| Rate for Payer: UHC Exchange |
$7.91
|
| Rate for Payer: UHC Medicare Advantage |
$7.91
|
| Rate for Payer: VA VA |
$7.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.71
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$25.81
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO |
$27.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.71
|
|
|
HC URINE CULTURE
|
Facility
|
IP
|
$40.08
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.05 |
| Max. Negotiated Rate |
$36.07 |
| Rate for Payer: Aetna Commercial |
$34.07
|
| Rate for Payer: BCBS Trust/PPO |
$32.72
|
| Rate for Payer: BCN Commercial |
$30.97
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cofinity Commercial |
$34.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.06
|
| Rate for Payer: Healthscope Commercial |
$36.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.07
|
| Rate for Payer: Nomi Health Commercial |
$32.87
|
| Rate for Payer: PHP Commercial |
$34.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.05
|
| Rate for Payer: Priority Health HMO/PPO |
$34.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.27
|
| Rate for Payer: UHC Core |
$33.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.06
|
|
|
HC URINE CULTURE
|
Facility
|
OP
|
$40.08
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$36.07 |
| Rate for Payer: Aetna Commercial |
$34.07
|
| Rate for Payer: Aetna Medicare |
$10.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.53
|
| Rate for Payer: BCBS Complete |
$6.13
|
| Rate for Payer: BCBS MAPPO |
$10.02
|
| Rate for Payer: BCBS Trust/PPO |
$32.95
|
| Rate for Payer: BCN Commercial |
$31.16
|
| Rate for Payer: BCN Medicare Advantage |
$10.02
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cofinity Commercial |
$34.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.02
|
| Rate for Payer: Healthscope Commercial |
$36.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.06
|
| Rate for Payer: Mclaren Medicaid |
$5.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.52
|
| Rate for Payer: Meridian Medicaid |
$6.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.07
|
| Rate for Payer: Nomi Health Commercial |
$32.87
|
| Rate for Payer: PACE Senior Care Partners |
$9.52
|
| Rate for Payer: PACE SWMI |
$10.02
|
| Rate for Payer: PHP Commercial |
$34.07
|
| Rate for Payer: PHP Medicare Advantage |
$10.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.05
|
| Rate for Payer: Priority Health HMO/PPO |
$34.87
|
| Rate for Payer: Priority Health Medicare |
$10.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.85
|
| Rate for Payer: Railroad Medicare Medicare |
$10.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.27
|
| Rate for Payer: UHC Core |
$33.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.02
|
| Rate for Payer: UHC Exchange |
$10.02
|
| Rate for Payer: UHC Medicare Advantage |
$10.02
|
| Rate for Payer: UHCCP Medicaid |
$5.83
|
| Rate for Payer: VA VA |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.06
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
IP
|
$25.27
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$22.74 |
| Rate for Payer: Aetna Commercial |
$21.48
|
| Rate for Payer: BCBS Trust/PPO |
$20.63
|
| Rate for Payer: BCN Commercial |
$19.53
|
| Rate for Payer: Cash Price |
$20.22
|
| Rate for Payer: Cofinity Commercial |
$21.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.22
|
| Rate for Payer: Healthscope Commercial |
$22.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.48
|
| Rate for Payer: Nomi Health Commercial |
$20.72
|
| Rate for Payer: PHP Commercial |
$21.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.43
|
| Rate for Payer: Priority Health HMO/PPO |
$21.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.24
|
| Rate for Payer: UHC Core |
$21.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.95
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
OP
|
$25.27
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$22.74 |
| Rate for Payer: Aetna Commercial |
$21.48
|
| Rate for Payer: Aetna Medicare |
$6.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.90
|
| Rate for Payer: BCBS Complete |
$13.01
|
| Rate for Payer: BCBS MAPPO |
$6.32
|
| Rate for Payer: BCBS Trust/PPO |
$20.77
|
| Rate for Payer: BCN Commercial |
$19.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.32
|
| Rate for Payer: Cash Price |
$20.22
|
| Rate for Payer: Cash Price |
$20.22
|
| Rate for Payer: Cofinity Commercial |
$21.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.32
|
| Rate for Payer: Healthscope Commercial |
$22.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.95
|
| Rate for Payer: Mclaren Medicaid |
$12.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.63
|
| Rate for Payer: Meridian Medicaid |
$13.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.48
|
| Rate for Payer: Nomi Health Commercial |
$20.72
|
| Rate for Payer: PACE Senior Care Partners |
$6.00
|
| Rate for Payer: PACE SWMI |
$6.32
|
| Rate for Payer: PHP Commercial |
$21.48
|
| Rate for Payer: PHP Medicare Advantage |
$6.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.43
|
| Rate for Payer: Priority Health HMO/PPO |
$21.98
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.24
|
| Rate for Payer: UHC Core |
$21.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.32
|
| Rate for Payer: UHC Exchange |
$6.32
|
| Rate for Payer: UHC Medicare Advantage |
$6.32
|
| Rate for Payer: UHCCP Medicaid |
$12.39
|
| Rate for Payer: VA VA |
$6.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.95
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$51.62
|
| Rate for Payer: BCN Commercial |
$48.87
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO |
$55.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.65
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna Medicare |
$16.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.76
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS MAPPO |
$15.81
|
| Rate for Payer: BCBS Trust/PPO |
$51.99
|
| Rate for Payer: BCN Commercial |
$49.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.81
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.81
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PACE Senior Care Partners |
$15.02
|
| Rate for Payer: PACE SWMI |
$15.81
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: PHP Medicare Advantage |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO |
$55.02
|
| Rate for Payer: Priority Health Medicare |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.37
|
| Rate for Payer: Railroad Medicare Medicare |
$15.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.65
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.81
|
| Rate for Payer: UHC Exchange |
$15.81
|
| Rate for Payer: UHC Medicare Advantage |
$15.81
|
| Rate for Payer: VA VA |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$6.54
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$6.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$6.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$6.23
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
IP
|
$65.08
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$58.57 |
| Rate for Payer: Aetna Commercial |
$55.32
|
| Rate for Payer: BCBS Trust/PPO |
$53.12
|
| Rate for Payer: BCN Commercial |
$50.29
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cofinity Commercial |
$55.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.06
|
| Rate for Payer: Healthscope Commercial |
$58.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.32
|
| Rate for Payer: Nomi Health Commercial |
$53.37
|
| Rate for Payer: PHP Commercial |
$55.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.30
|
| Rate for Payer: Priority Health HMO/PPO |
$56.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.27
|
| Rate for Payer: UHC Core |
$54.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.81
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
OP
|
$65.08
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$58.57 |
| Rate for Payer: Aetna Commercial |
$55.32
|
| Rate for Payer: Aetna Medicare |
$16.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.34
|
| Rate for Payer: BCBS Complete |
$6.14
|
| Rate for Payer: BCBS MAPPO |
$16.27
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$50.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.27
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cofinity Commercial |
$55.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.27
|
| Rate for Payer: Healthscope Commercial |
$58.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.81
|
| Rate for Payer: Mclaren Medicaid |
$5.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.08
|
| Rate for Payer: Meridian Medicaid |
$6.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.32
|
| Rate for Payer: Nomi Health Commercial |
$53.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.46
|
| Rate for Payer: PACE SWMI |
$16.27
|
| Rate for Payer: PHP Commercial |
$55.32
|
| Rate for Payer: PHP Medicare Advantage |
$16.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.30
|
| Rate for Payer: Priority Health HMO/PPO |
$56.62
|
| Rate for Payer: Priority Health Medicare |
$16.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.60
|
| Rate for Payer: Railroad Medicare Medicare |
$16.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.27
|
| Rate for Payer: UHC Core |
$54.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.27
|
| Rate for Payer: UHC Exchange |
$16.27
|
| Rate for Payer: UHC Medicare Advantage |
$16.27
|
| Rate for Payer: UHCCP Medicaid |
$5.85
|
| Rate for Payer: VA VA |
$16.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.81
|
|
|
HC URINE REDUCING SUBSTANCES
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC URINE REDUCING SUBSTANCES
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$1.65
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$1.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$1.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$1.57
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC URIN MDMA
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.16
|
| Rate for Payer: BCN Commercial |
$73.05
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC URIN MDMA
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$23.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$73.50
|
| Rate for Payer: BCN Medicare Advantage |
$23.63
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.63
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.81
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.45
|
| Rate for Payer: PACE SWMI |
$23.63
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Medicare |
$23.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.63
|
| Rate for Payer: UHC Exchange |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$23.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
