|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
IP
|
$57.50
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.07 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$48.88
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$44.44
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cofinity Commercial |
$49.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$51.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
| Rate for Payer: PHP Commercial |
$48.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.60
|
| Rate for Payer: UHC Core |
$48.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.12
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
OP
|
$57.50
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.67 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$48.88
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.97
|
| Rate for Payer: BCBS Complete |
$11.21
|
| Rate for Payer: BCBS MAPPO |
$14.38
|
| Rate for Payer: BCBS Trust/PPO |
$44.71
|
| Rate for Payer: BCN Commercial |
$44.71
|
| Rate for Payer: BCN Medicare Advantage |
$14.38
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cofinity Commercial |
$49.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.38
|
| Rate for Payer: Healthscope Commercial |
$51.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.12
|
| Rate for Payer: Mclaren Medicaid |
$10.67
|
| Rate for Payer: Meridian Medicaid |
$11.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
| Rate for Payer: PACE Senior Care Partners |
$13.66
|
| Rate for Payer: PACE SWMI |
$14.38
|
| Rate for Payer: PHP Commercial |
$48.88
|
| Rate for Payer: PHP Medicare Advantage |
$14.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.02
|
| Rate for Payer: Priority Health Medicare |
$14.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
| Rate for Payer: Railroad Medicare Medicare |
$14.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.60
|
| Rate for Payer: UHC Core |
$48.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.38
|
| Rate for Payer: UHC Medicare Advantage |
$14.81
|
| Rate for Payer: VA VA |
$14.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.12
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$144.50
|
| Rate for Payer: Aetna Medicare |
$44.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.12
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$42.50
|
| Rate for Payer: BCBS Trust/PPO |
$132.18
|
| Rate for Payer: BCN Commercial |
$132.18
|
| Rate for Payer: BCN Medicare Advantage |
$42.50
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$146.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.50
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.50
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.50
|
| Rate for Payer: PACE Senior Care Partners |
$40.38
|
| Rate for Payer: PACE SWMI |
$42.50
|
| Rate for Payer: PHP Commercial |
$144.50
|
| Rate for Payer: PHP Medicare Advantage |
$42.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.90
|
| Rate for Payer: Priority Health Medicare |
$42.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.68
|
| Rate for Payer: Railroad Medicare Medicare |
$42.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.60
|
| Rate for Payer: UHC Core |
$141.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.50
|
| Rate for Payer: UHC Medicare Advantage |
$43.78
|
| Rate for Payer: VA VA |
$42.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.50
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$103.68 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$144.50
|
| Rate for Payer: BCBS Trust/PPO |
$131.38
|
| Rate for Payer: BCN Commercial |
$131.38
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$146.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.00
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.50
|
| Rate for Payer: PHP Commercial |
$144.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.60
|
| Rate for Payer: UHC Core |
$141.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.50
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
IP
|
$73.10
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.58 |
| Max. Negotiated Rate |
$65.79 |
| Rate for Payer: Aetna Commercial |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$56.49
|
| Rate for Payer: BCN Commercial |
$56.49
|
| Rate for Payer: Cash Price |
$58.48
|
| Rate for Payer: Cofinity Commercial |
$62.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.48
|
| Rate for Payer: Healthscope Commercial |
$65.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.14
|
| Rate for Payer: PHP Commercial |
$62.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.33
|
| Rate for Payer: UHC Core |
$61.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.82
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
OP
|
$73.10
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.55 |
| Max. Negotiated Rate |
$65.79 |
| Rate for Payer: Aetna Commercial |
$62.14
|
| Rate for Payer: Aetna Medicare |
$19.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.84
|
| Rate for Payer: BCBS Complete |
$13.17
|
| Rate for Payer: BCBS MAPPO |
$18.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.84
|
| Rate for Payer: BCN Commercial |
$56.84
|
| Rate for Payer: BCN Medicare Advantage |
$18.28
|
| Rate for Payer: Cash Price |
$58.48
|
| Rate for Payer: Cash Price |
$58.48
|
| Rate for Payer: Cofinity Commercial |
$62.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.28
|
| Rate for Payer: Healthscope Commercial |
$65.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.82
|
| Rate for Payer: Mclaren Medicaid |
$12.55
|
| Rate for Payer: Meridian Medicaid |
$13.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.14
|
| Rate for Payer: PACE Senior Care Partners |
$17.36
|
| Rate for Payer: PACE SWMI |
$18.28
|
| Rate for Payer: PHP Commercial |
$62.14
|
| Rate for Payer: PHP Medicare Advantage |
$18.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.60
|
| Rate for Payer: Priority Health Medicare |
$18.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.58
|
| Rate for Payer: Railroad Medicare Medicare |
$18.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.33
|
| Rate for Payer: UHC Core |
$61.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.28
|
| Rate for Payer: UHC Medicare Advantage |
$18.82
|
| Rate for Payer: VA VA |
$18.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.82
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
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
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
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 |
$13.00
|
| 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 |
$12.38
|
| Rate for Payer: Meridian Medicaid |
$13.00
|
| 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 |
$12.38
|
| 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 FETOPROTEIN TUMOR MARKER
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.38 |
| 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 |
$13.00
|
| Rate for Payer: BCBS MAPPO |
$15.81
|
| Rate for Payer: BCBS Trust/PPO |
$49.17
|
| 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: 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: Mclaren Medicaid |
$12.38
|
| Rate for Payer: Meridian Medicaid |
$13.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.75
|
| 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 Choice Medicaid |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.02
|
| Rate for Payer: Priority Health Medicare |
$15.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.57
|
| 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 Medicare Advantage |
$16.28
|
| Rate for Payer: VA VA |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC ALPHA FETOPROTEIN TUMOR MARKER
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$48.87
|
| 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 Multiplan/Beech St/PHCS |
$53.75
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.57
|
| 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 ALTEPLASE RECOMBINANT, PER 1 MG
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
63600144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.88 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.70
|
| Rate for Payer: BCBS Trust/PPO |
$67.00
|
| Rate for Payer: BCN Commercial |
$67.00
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.70
|
| Rate for Payer: PHP Commercial |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.02
|
|
|
HC ALTEPLASE RECOMBINANT, PER 1 MG
|
Facility
|
OP
|
$86.70
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
63600144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.59 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.70
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.09
|
| Rate for Payer: BCBS Complete |
$68.95
|
| Rate for Payer: BCBS MAPPO |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$67.41
|
| Rate for Payer: BCN Commercial |
$67.41
|
| Rate for Payer: BCN Medicare Advantage |
$21.68
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.68
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.02
|
| Rate for Payer: Mclaren Medicaid |
$65.66
|
| Rate for Payer: Meridian Medicaid |
$68.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.70
|
| Rate for Payer: PACE Senior Care Partners |
$20.59
|
| Rate for Payer: PACE SWMI |
$21.68
|
| Rate for Payer: PHP Commercial |
$73.70
|
| Rate for Payer: PHP Medicare Advantage |
$21.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.43
|
| Rate for Payer: Priority Health Medicare |
$21.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.88
|
| Rate for Payer: Railroad Medicare Medicare |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.68
|
| Rate for Payer: UHC Medicare Advantage |
$22.33
|
| Rate for Payer: VA VA |
$21.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.02
|
|
|
HC ALTERNARIA IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200027
|
|
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 ALTERNARIA IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200027
|
|
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 ALUMINUM
|
Facility
|
OP
|
$55.08
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
30100088
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.08 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$14.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.21
|
| Rate for Payer: BCBS Complete |
$19.74
|
| Rate for Payer: BCBS MAPPO |
$13.77
|
| Rate for Payer: BCBS Trust/PPO |
$42.82
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$13.77
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.77
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$19.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.82
|
| Rate for Payer: PACE Senior Care Partners |
$13.08
|
| Rate for Payer: PACE SWMI |
$13.77
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: PHP Medicare Advantage |
$13.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.92
|
| Rate for Payer: Priority Health Medicare |
$13.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.47
|
| Rate for Payer: UHC Core |
$45.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.77
|
| Rate for Payer: UHC Medicare Advantage |
$14.18
|
| Rate for Payer: VA VA |
$13.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC ALUMINUM
|
Facility
|
IP
|
$55.08
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
30100088
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.59 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: BCBS Trust/PPO |
$42.57
|
| Rate for Payer: BCN Commercial |
$42.57
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.82
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.47
|
| Rate for Payer: UHC Core |
$45.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC AMIKACIN LEVEL
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
30100006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$11.69
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$59.80
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$11.13
|
| Rate for Payer: Meridian Medicaid |
$11.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.37
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.91
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.80
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC AMIKACIN LEVEL
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
30100006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.91 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$59.44
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC AMINO ACID FRACTIONATION
|
Facility
|
IP
|
$155.04
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100091
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.56 |
| Max. Negotiated Rate |
$139.54 |
| Rate for Payer: Aetna Commercial |
$131.78
|
| Rate for Payer: BCBS Trust/PPO |
$119.81
|
| Rate for Payer: BCN Commercial |
$119.81
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$133.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Healthscope Commercial |
$139.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.78
|
| Rate for Payer: PHP Commercial |
$131.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.44
|
| Rate for Payer: UHC Core |
$129.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.28
|
|
|
HC AMINO ACID FRACTIONATION
|
Facility
|
OP
|
$155.04
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100091
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$139.54 |
| Rate for Payer: Aetna Commercial |
$131.78
|
| Rate for Payer: Aetna Medicare |
$40.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.45
|
| Rate for Payer: BCBS Complete |
$13.07
|
| Rate for Payer: BCBS MAPPO |
$38.76
|
| Rate for Payer: BCBS Trust/PPO |
$120.54
|
| Rate for Payer: BCN Commercial |
$120.54
|
| Rate for Payer: BCN Medicare Advantage |
$38.76
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$133.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.76
|
| Rate for Payer: Healthscope Commercial |
$139.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.28
|
| Rate for Payer: Mclaren Medicaid |
$12.45
|
| Rate for Payer: Meridian Medicaid |
$13.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.78
|
| Rate for Payer: PACE Senior Care Partners |
$36.82
|
| Rate for Payer: PACE SWMI |
$38.76
|
| Rate for Payer: PHP Commercial |
$131.78
|
| Rate for Payer: PHP Medicare Advantage |
$38.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.88
|
| Rate for Payer: Priority Health Medicare |
$38.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.56
|
| Rate for Payer: Railroad Medicare Medicare |
$38.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.44
|
| Rate for Payer: UHC Core |
$129.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.76
|
| Rate for Payer: UHC Medicare Advantage |
$39.92
|
| Rate for Payer: VA VA |
$38.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.28
|
|
|
HC AMINO ACID QUANT CSF
|
Facility
|
IP
|
$229.50
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100093
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$139.97 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: BCBS Trust/PPO |
$177.36
|
| Rate for Payer: BCN Commercial |
$177.36
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.96
|
| Rate for Payer: UHC Core |
$191.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC AMINO ACID QUANT CSF
|
Facility
|
OP
|
$229.50
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100093
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.72
|
| Rate for Payer: BCBS Complete |
$13.07
|
| Rate for Payer: BCBS MAPPO |
$57.38
|
| Rate for Payer: BCBS Trust/PPO |
$178.44
|
| Rate for Payer: BCN Commercial |
$178.44
|
| Rate for Payer: BCN Medicare Advantage |
$57.38
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.38
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Mclaren Medicaid |
$12.45
|
| Rate for Payer: Meridian Medicaid |
$13.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: PACE Senior Care Partners |
$54.51
|
| Rate for Payer: PACE SWMI |
$57.38
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: PHP Medicare Advantage |
$57.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.66
|
| Rate for Payer: Priority Health Medicare |
$57.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.97
|
| Rate for Payer: Railroad Medicare Medicare |
$57.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.96
|
| Rate for Payer: UHC Core |
$191.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.38
|
| Rate for Payer: UHC Medicare Advantage |
$59.10
|
| Rate for Payer: VA VA |
$57.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC AMINO ACID QUANT RANDOM URINE
|
Facility
|
IP
|
$209.10
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100092
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$127.53 |
| Max. Negotiated Rate |
$188.19 |
| Rate for Payer: Aetna Commercial |
$177.74
|
| Rate for Payer: BCBS Trust/PPO |
$161.59
|
| Rate for Payer: BCN Commercial |
$161.59
|
| Rate for Payer: Cash Price |
$167.28
|
| Rate for Payer: Cofinity Commercial |
$179.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.28
|
| Rate for Payer: Healthscope Commercial |
$188.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.74
|
| Rate for Payer: PHP Commercial |
$177.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.01
|
| Rate for Payer: UHC Core |
$174.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.82
|
|
