|
HC VITAMIN D
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN D
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$22.47
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$21.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$21.40
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.87 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: BCBS Trust/PPO |
$76.44
|
| Rate for Payer: BCN Commercial |
$72.36
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.24 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$29.23
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$76.98
|
| Rate for Payer: BCN Commercial |
$72.81
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$27.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$29.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.24
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.74
|
| Rate for Payer: Railroad Medicare Medicare |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.41
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$27.84
|
| Rate for Payer: VA VA |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$22.47
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$21.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$21.40
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.25 |
| 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 |
$10.77
|
| 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 |
$10.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$10.77
|
| 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 |
$10.25
|
| 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 |
$10.25
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
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 VITAMIN K LEVEL
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: Aetna Medicare |
$31.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.25
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$100.63
|
| Rate for Payer: BCN Commercial |
$95.17
|
| Rate for Payer: BCN Medicare Advantage |
$30.60
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.13
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.04
|
| Rate for Payer: Nomi Health Commercial |
$100.37
|
| Rate for Payer: PACE Senior Care Partners |
$29.07
|
| Rate for Payer: PACE SWMI |
$30.60
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: PHP Medicare Advantage |
$30.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health HMO/PPO |
$106.49
|
| Rate for Payer: Priority Health Medicare |
$30.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.01
|
| Rate for Payer: Railroad Medicare Medicare |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.60
|
| Rate for Payer: UHC Exchange |
$30.60
|
| Rate for Payer: UHC Medicare Advantage |
$30.60
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$30.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.56 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: BCBS Trust/PPO |
$99.92
|
| Rate for Payer: BCN Commercial |
$94.59
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.04
|
| Rate for Payer: Nomi Health Commercial |
$100.37
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health HMO/PPO |
$106.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$23.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.05
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$73.79
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: BCN Medicare Advantage |
$22.44
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.44
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Mclaren Medicaid |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.56
|
| Rate for Payer: Meridian Medicaid |
$11.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: PACE Senior Care Partners |
$21.32
|
| Rate for Payer: PACE SWMI |
$22.44
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO |
$78.09
|
| Rate for Payer: Priority Health Medicare |
$22.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: Railroad Medicare Medicare |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.44
|
| Rate for Payer: UHC Exchange |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$22.44
|
| Rate for Payer: UHCCP Medicaid |
$11.21
|
| Rate for Payer: VA VA |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: BCBS Trust/PPO |
$73.27
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO |
$78.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: BCBS Trust/PPO |
$41.61
|
| Rate for Payer: BCN Commercial |
$39.40
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.93
|
| Rate for Payer: BCBS Complete |
$17.01
|
| Rate for Payer: BCBS MAPPO |
$12.74
|
| Rate for Payer: BCBS Trust/PPO |
$41.91
|
| Rate for Payer: BCN Commercial |
$39.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.74
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Mclaren Medicaid |
$16.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.38
|
| Rate for Payer: Meridian Medicaid |
$17.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.74
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: Railroad Medicare Medicare |
$12.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.74
|
| Rate for Payer: UHC Exchange |
$12.74
|
| Rate for Payer: UHC Medicare Advantage |
$12.74
|
| Rate for Payer: UHCCP Medicaid |
$16.20
|
| Rate for Payer: VA VA |
$12.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Mclaren Medicaid |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$11.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$12.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$11.21
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.13
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.13
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC VMA URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Mclaren Medicaid |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$11.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$12.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$11.21
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$5,127.14
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,217.70 |
| Max. Negotiated Rate |
$4,614.43 |
| Rate for Payer: Aetna Commercial |
$4,358.07
|
| Rate for Payer: Aetna Medicare |
$1,333.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,602.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,602.23
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$1,281.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,215.02
|
| Rate for Payer: BCN Commercial |
$3,986.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,281.79
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cofinity Commercial |
$4,409.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,101.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,281.79
|
| Rate for Payer: Healthscope Commercial |
$4,614.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,845.36
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,345.87
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,474.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.07
|
| Rate for Payer: Nomi Health Commercial |
$4,204.25
|
| Rate for Payer: PACE Senior Care Partners |
$1,217.70
|
| Rate for Payer: PACE SWMI |
$1,281.79
|
| Rate for Payer: PHP Commercial |
$4,358.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,281.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,332.64
|
| Rate for Payer: Priority Health HMO/PPO |
$4,460.61
|
| Rate for Payer: Priority Health Medicare |
$1,294.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,435.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,281.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,511.88
|
| Rate for Payer: UHC Core |
$4,281.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,281.79
|
| Rate for Payer: UHC Exchange |
$1,281.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,281.79
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$1,281.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,845.36
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$5,127.14
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,332.64 |
| Max. Negotiated Rate |
$4,614.43 |
| Rate for Payer: Aetna Commercial |
$4,358.07
|
| Rate for Payer: BCBS Trust/PPO |
$4,185.28
|
| Rate for Payer: BCN Commercial |
$3,962.25
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cofinity Commercial |
$4,409.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,101.71
|
| Rate for Payer: Healthscope Commercial |
$4,614.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,845.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.07
|
| Rate for Payer: Nomi Health Commercial |
$4,204.25
|
| Rate for Payer: PHP Commercial |
$4,358.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,332.64
|
| Rate for Payer: Priority Health HMO/PPO |
$4,460.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,435.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,511.88
|
| Rate for Payer: UHC Core |
$4,281.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,845.36
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,505.14
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,628.34 |
| Max. Negotiated Rate |
$2,254.63 |
| Rate for Payer: Aetna Commercial |
$2,129.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,044.95
|
| Rate for Payer: BCN Commercial |
$1,935.97
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cofinity Commercial |
$2,154.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.11
|
| Rate for Payer: Healthscope Commercial |
$2,254.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,878.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,129.37
|
| Rate for Payer: Nomi Health Commercial |
$2,054.21
|
| Rate for Payer: PHP Commercial |
$2,129.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.34
|
| Rate for Payer: Priority Health HMO/PPO |
$2,179.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,678.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,204.52
|
| Rate for Payer: UHC Core |
$2,091.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,878.86
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,505.14
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.97 |
| Max. Negotiated Rate |
$2,254.63 |
| Rate for Payer: Aetna Commercial |
$2,129.37
|
| Rate for Payer: Aetna Medicare |
$651.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.86
|
| Rate for Payer: BCBS Complete |
$1,002.06
|
| Rate for Payer: BCBS MAPPO |
$626.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,059.48
|
| Rate for Payer: BCN Commercial |
$1,947.75
|
| Rate for Payer: BCN Medicare Advantage |
$626.28
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cofinity Commercial |
$2,154.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.28
|
| Rate for Payer: Healthscope Commercial |
$2,254.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,878.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$720.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,129.37
|
| Rate for Payer: Nomi Health Commercial |
$2,054.21
|
| Rate for Payer: PACE Senior Care Partners |
$594.97
|
| Rate for Payer: PACE SWMI |
$626.28
|
| Rate for Payer: PHP Commercial |
$2,129.37
|
| Rate for Payer: PHP Medicare Advantage |
$626.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.34
|
| Rate for Payer: Priority Health HMO/PPO |
$2,179.47
|
| Rate for Payer: Priority Health Medicare |
$632.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,678.44
|
| Rate for Payer: Railroad Medicare Medicare |
$626.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,204.52
|
| Rate for Payer: UHC Core |
$2,091.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.28
|
| Rate for Payer: UHC Exchange |
$626.28
|
| Rate for Payer: UHC Medicare Advantage |
$626.28
|
| Rate for Payer: VA VA |
$626.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,878.86
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$262.22
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$62.28 |
| Max. Negotiated Rate |
$236.00 |
| Rate for Payer: Aetna Commercial |
$222.89
|
| Rate for Payer: Aetna Medicare |
$68.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.94
|
| Rate for Payer: BCBS Complete |
$104.89
|
| Rate for Payer: BCBS MAPPO |
$65.56
|
| Rate for Payer: BCBS Trust/PPO |
$215.57
|
| Rate for Payer: BCN Commercial |
$203.88
|
| Rate for Payer: BCN Medicare Advantage |
$65.56
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$225.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.56
|
| Rate for Payer: Healthscope Commercial |
$236.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.89
|
| Rate for Payer: Nomi Health Commercial |
$215.02
|
| Rate for Payer: PACE Senior Care Partners |
$62.28
|
| Rate for Payer: PACE SWMI |
$65.56
|
| Rate for Payer: PHP Commercial |
$222.89
|
| Rate for Payer: PHP Medicare Advantage |
$65.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.44
|
| Rate for Payer: Priority Health HMO/PPO |
$228.13
|
| Rate for Payer: Priority Health Medicare |
$66.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.69
|
| Rate for Payer: Railroad Medicare Medicare |
$65.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.75
|
| Rate for Payer: UHC Core |
$218.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.56
|
| Rate for Payer: UHC Exchange |
$65.56
|
| Rate for Payer: UHC Medicare Advantage |
$65.56
|
| Rate for Payer: VA VA |
$65.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.66
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$262.22
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$170.44 |
| Max. Negotiated Rate |
$236.00 |
| Rate for Payer: Aetna Commercial |
$222.89
|
| Rate for Payer: BCBS Trust/PPO |
$214.05
|
| Rate for Payer: BCN Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$225.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.78
|
| Rate for Payer: Healthscope Commercial |
$236.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.89
|
| Rate for Payer: Nomi Health Commercial |
$215.02
|
| Rate for Payer: PHP Commercial |
$222.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.44
|
| Rate for Payer: Priority Health HMO/PPO |
$228.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.75
|
| Rate for Payer: UHC Core |
$218.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.66
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$19.67
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$17.70 |
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: BCBS Trust/PPO |
$16.06
|
| Rate for Payer: BCN Commercial |
$15.20
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$16.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Healthscope Commercial |
$17.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$16.13
|
| Rate for Payer: PHP Commercial |
$16.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: Priority Health HMO/PPO |
$17.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.31
|
| Rate for Payer: UHC Core |
$16.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.75
|
|
