|
HC ALLERGY SCREEN FISH
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200020
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN INDOOR 1 ALLERG
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN INDOOR 1 ALLERG
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN MOLDS
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN MOLDS
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: BCBS Trust/PPO |
$17.34
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.01
|
| Rate for Payer: BCBS Complete |
$4.52
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Meridian Medicaid |
$4.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.33
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: VA VA |
$5.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC ALMONDS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALMONDS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
OP
|
$48.44
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$43.60 |
| Rate for Payer: Aetna Commercial |
$41.17
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$19.38
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$37.66
|
| Rate for Payer: BCN Commercial |
$37.66
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$43.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.17
|
| Rate for Payer: PACE Senior Care Partners |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$41.17
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.14
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.54
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.63
|
| Rate for Payer: UHC Core |
$40.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.11
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: VA VA |
$12.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.33
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
IP
|
$48.44
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$29.54 |
| Max. Negotiated Rate |
$43.60 |
| Rate for Payer: Aetna Commercial |
$41.17
|
| Rate for Payer: BCBS Trust/PPO |
$37.43
|
| Rate for Payer: BCN Commercial |
$37.43
|
| Rate for Payer: Cash Price |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$43.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.17
|
| Rate for Payer: PHP Commercial |
$41.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.63
|
| Rate for Payer: UHC Core |
$40.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.33
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
IP
|
$16.45
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$14.80 |
| Rate for Payer: Aetna Commercial |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$12.71
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: Cash Price |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$14.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.16
|
| Rate for Payer: Healthscope Commercial |
$14.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.98
|
| Rate for Payer: PHP Commercial |
$13.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.48
|
| Rate for Payer: UHC Core |
$13.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.34
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
OP
|
$16.45
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$14.80 |
| Rate for Payer: Aetna Commercial |
$13.98
|
| Rate for Payer: Aetna Medicare |
$4.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.14
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$4.11
|
| Rate for Payer: BCBS Trust/PPO |
$12.79
|
| Rate for Payer: BCN Commercial |
$12.79
|
| Rate for Payer: BCN Medicare Advantage |
$4.11
|
| Rate for Payer: Cash Price |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$14.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.11
|
| Rate for Payer: Healthscope Commercial |
$14.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.98
|
| Rate for Payer: PACE Senior Care Partners |
$3.91
|
| Rate for Payer: PACE SWMI |
$4.11
|
| Rate for Payer: PHP Commercial |
$13.98
|
| Rate for Payer: PHP Medicare Advantage |
$4.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.31
|
| Rate for Payer: Priority Health Medicare |
$4.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.03
|
| Rate for Payer: Railroad Medicare Medicare |
$4.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.48
|
| Rate for Payer: UHC Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.11
|
| Rate for Payer: UHC Medicare Advantage |
$4.24
|
| Rate for Payer: VA VA |
$4.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.34
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
OP
|
$41.48
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$37.33 |
| Rate for Payer: Aetna Commercial |
$35.26
|
| Rate for Payer: Aetna Medicare |
$10.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.96
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: BCBS MAPPO |
$10.37
|
| Rate for Payer: BCBS Trust/PPO |
$32.25
|
| Rate for Payer: BCN Commercial |
$32.25
|
| Rate for Payer: BCN Medicare Advantage |
$10.37
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.37
|
| Rate for Payer: Healthscope Commercial |
$37.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.26
|
| Rate for Payer: PACE Senior Care Partners |
$9.85
|
| Rate for Payer: PACE SWMI |
$10.37
|
| Rate for Payer: PHP Commercial |
$35.26
|
| Rate for Payer: PHP Medicare Advantage |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.09
|
| Rate for Payer: Priority Health Medicare |
$10.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.30
|
| Rate for Payer: Railroad Medicare Medicare |
$10.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.50
|
| Rate for Payer: UHC Core |
$34.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.37
|
| Rate for Payer: UHC Medicare Advantage |
$10.68
|
| Rate for Payer: VA VA |
$10.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.11
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
IP
|
$41.48
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$37.33 |
| Rate for Payer: Aetna Commercial |
$35.26
|
| Rate for Payer: BCBS Trust/PPO |
$32.06
|
| Rate for Payer: BCN Commercial |
$32.06
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$37.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.26
|
| Rate for Payer: PHP Commercial |
$35.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.50
|
| Rate for Payer: UHC Core |
$34.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.11
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.67 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: Aetna Medicare |
$15.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.12
|
| Rate for Payer: BCBS Complete |
$11.21
|
| Rate for Payer: BCBS MAPPO |
$14.50
|
| Rate for Payer: BCBS Trust/PPO |
$45.10
|
| Rate for Payer: BCN Commercial |
$45.10
|
| Rate for Payer: BCN Medicare Advantage |
$14.50
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.50
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.50
|
| Rate for Payer: Mclaren Medicaid |
$10.67
|
| Rate for Payer: Meridian Medicaid |
$11.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PACE Senior Care Partners |
$13.78
|
| Rate for Payer: PACE SWMI |
$14.50
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: PHP Medicare Advantage |
$14.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.46
|
| Rate for Payer: Priority Health Medicare |
$14.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.37
|
| Rate for Payer: Railroad Medicare Medicare |
$14.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.04
|
| Rate for Payer: UHC Core |
$48.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.50
|
| Rate for Payer: UHC Medicare Advantage |
$14.94
|
| Rate for Payer: VA VA |
$14.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.50
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: BCBS Trust/PPO |
$44.82
|
| Rate for Payer: BCN Commercial |
$44.82
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.04
|
| Rate for Payer: UHC Core |
$48.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.50
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna Medicare |
$11.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.39
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$10.71
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: BCN Medicare Advantage |
$10.71
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.71
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PACE Senior Care Partners |
$10.17
|
| Rate for Payer: PACE SWMI |
$10.71
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: PHP Medicare Advantage |
$10.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.27
|
| Rate for Payer: Priority Health Medicare |
$10.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: Railroad Medicare Medicare |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.71
|
| Rate for Payer: UHC Medicare Advantage |
$11.03
|
| Rate for Payer: VA VA |
$10.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.13 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$33.11
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.92
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Senior Care Partners |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.92
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.19
|
| Rate for Payer: VA VA |
$8.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.77 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$27.59
|
| Rate for Payer: BCN Commercial |
$27.59
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
