|
HC AMINO ACID QUANT RANDOM URINE
|
Facility
|
OP
|
$209.10
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100092
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$188.19 |
| Rate for Payer: Aetna Commercial |
$177.74
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.34
|
| Rate for Payer: BCBS Complete |
$13.07
|
| Rate for Payer: BCBS MAPPO |
$52.28
|
| Rate for Payer: BCBS Trust/PPO |
$162.58
|
| Rate for Payer: BCN Commercial |
$162.58
|
| Rate for Payer: BCN Medicare Advantage |
$52.28
|
| Rate for Payer: Cash Price |
$167.28
|
| 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: Health Alliance Plan Medicare Advantage |
$52.28
|
| Rate for Payer: Healthscope Commercial |
$188.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.82
|
| Rate for Payer: Mclaren Medicaid |
$12.45
|
| Rate for Payer: Meridian Medicaid |
$13.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.74
|
| Rate for Payer: PACE Senior Care Partners |
$49.66
|
| Rate for Payer: PACE SWMI |
$52.28
|
| Rate for Payer: PHP Commercial |
$177.74
|
| Rate for Payer: PHP Medicare Advantage |
$52.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.45
|
| 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 Medicare |
$52.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.53
|
| Rate for Payer: Railroad Medicare Medicare |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.01
|
| Rate for Payer: UHC Core |
$174.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.28
|
| Rate for Payer: UHC Medicare Advantage |
$53.84
|
| Rate for Payer: VA VA |
$52.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.82
|
|
|
HC AMINOLEVULINIC ACID URINE
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
CPT 82135
|
| Hospital Charge Code |
30100089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$77.40 |
| Rate for Payer: Aetna Commercial |
$73.10
|
| Rate for Payer: Aetna Medicare |
$22.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.88
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$21.50
|
| Rate for Payer: BCBS Trust/PPO |
$66.86
|
| Rate for Payer: BCN Commercial |
$66.86
|
| Rate for Payer: BCN Medicare Advantage |
$21.50
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$73.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$77.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.50
|
| Rate for Payer: Mclaren Medicaid |
$12.14
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.10
|
| Rate for Payer: PACE Senior Care Partners |
$20.42
|
| Rate for Payer: PACE SWMI |
$21.50
|
| Rate for Payer: PHP Commercial |
$73.10
|
| Rate for Payer: PHP Medicare Advantage |
$21.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.82
|
| Rate for Payer: Priority Health Medicare |
$21.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.45
|
| Rate for Payer: Railroad Medicare Medicare |
$21.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.68
|
| Rate for Payer: UHC Core |
$71.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.50
|
| Rate for Payer: UHC Medicare Advantage |
$22.14
|
| Rate for Payer: VA VA |
$21.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.50
|
|
|
HC AMINOLEVULINIC ACID URINE
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
CPT 82135
|
| Hospital Charge Code |
30100089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.45 |
| Max. Negotiated Rate |
$77.40 |
| Rate for Payer: Aetna Commercial |
$73.10
|
| Rate for Payer: BCBS Trust/PPO |
$66.46
|
| Rate for Payer: BCN Commercial |
$66.46
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$73.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.80
|
| Rate for Payer: Healthscope Commercial |
$77.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.10
|
| Rate for Payer: PHP Commercial |
$73.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.68
|
| Rate for Payer: UHC Core |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.50
|
|
|
HC AMIODARONE/CORDARONE LEVEL
|
Facility
|
IP
|
$39.07
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100287
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.83 |
| Max. Negotiated Rate |
$35.16 |
| Rate for Payer: Aetna Commercial |
$33.21
|
| Rate for Payer: BCBS Trust/PPO |
$30.19
|
| Rate for Payer: BCN Commercial |
$30.19
|
| Rate for Payer: Cash Price |
$31.26
|
| Rate for Payer: Cofinity Commercial |
$33.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.26
|
| Rate for Payer: Healthscope Commercial |
$35.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.21
|
| Rate for Payer: PHP Commercial |
$33.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.38
|
| Rate for Payer: UHC Core |
$32.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
HC AMIODARONE/CORDARONE LEVEL
|
Facility
|
OP
|
$39.07
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100287
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$35.16 |
| Rate for Payer: Aetna Commercial |
$33.21
|
| Rate for Payer: Aetna Medicare |
$10.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.21
|
| Rate for Payer: BCBS Complete |
$18.67
|
| Rate for Payer: BCBS MAPPO |
$9.77
|
| Rate for Payer: BCBS Trust/PPO |
$30.38
|
| Rate for Payer: BCN Commercial |
$30.38
|
| Rate for Payer: BCN Medicare Advantage |
$9.77
|
| Rate for Payer: Cash Price |
$31.26
|
| Rate for Payer: Cash Price |
$31.26
|
| Rate for Payer: Cofinity Commercial |
$33.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.77
|
| Rate for Payer: Healthscope Commercial |
$35.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Mclaren Medicaid |
$17.78
|
| Rate for Payer: Meridian Medicaid |
$18.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.21
|
| Rate for Payer: PACE Senior Care Partners |
$9.28
|
| Rate for Payer: PACE SWMI |
$9.77
|
| Rate for Payer: PHP Commercial |
$33.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.99
|
| Rate for Payer: Priority Health Medicare |
$9.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.83
|
| Rate for Payer: Railroad Medicare Medicare |
$9.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.38
|
| Rate for Payer: UHC Core |
$32.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.77
|
| Rate for Payer: UHC Medicare Advantage |
$10.06
|
| Rate for Payer: VA VA |
$9.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
HC AMITRIPTYLINE
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
30100563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.23 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: BCBS Trust/PPO |
$33.23
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.84
|
| Rate for Payer: UHC Core |
$35.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC AMITRIPTYLINE
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
30100563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Medicare |
$11.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.44
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$10.75
|
| Rate for Payer: BCBS Trust/PPO |
$33.43
|
| Rate for Payer: BCN Commercial |
$33.43
|
| Rate for Payer: BCN Medicare Advantage |
$10.75
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.75
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PACE Senior Care Partners |
$10.21
|
| Rate for Payer: PACE SWMI |
$10.75
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.41
|
| Rate for Payer: Priority Health Medicare |
$10.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.23
|
| Rate for Payer: Railroad Medicare Medicare |
$10.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.84
|
| Rate for Payer: UHC Core |
$35.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.75
|
| Rate for Payer: UHC Medicare Advantage |
$11.07
|
| Rate for Payer: VA VA |
$10.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC AMMONIA LEVEL
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
30100094
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.84
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC AMMONIA LEVEL
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
30100094
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.75 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$11.29
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$38.07
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$10.75
|
| Rate for Payer: Meridian Medicaid |
$11.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.61
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC AMNIOCENTESIS
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
76100006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: BCBS Trust/PPO |
$618.65
|
| Rate for Payer: BCN Commercial |
$618.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC AMNIOCENTESIS
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
76100006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$190.13 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.17
|
| Rate for Payer: BCBS Complete |
$220.97
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCBS Trust/PPO |
$622.41
|
| Rate for Payer: BCN Commercial |
$622.41
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$210.45
|
| Rate for Payer: Meridian Medicaid |
$220.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Senior Care Partners |
$190.13
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.13
|
| Rate for Payer: UHC Medicare Advantage |
$206.14
|
| Rate for Payer: VA VA |
$200.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
36100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.90 |
| Max. Negotiated Rate |
$553.73 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna Medicare |
$111.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.08
|
| Rate for Payer: BCBS Complete |
$553.73
|
| Rate for Payer: BCBS MAPPO |
$107.26
|
| Rate for Payer: BCBS Trust/PPO |
$333.59
|
| Rate for Payer: BCN Commercial |
$333.59
|
| Rate for Payer: BCN Medicare Advantage |
$107.26
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.26
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Mclaren Medicaid |
$527.36
|
| Rate for Payer: Meridian Medicaid |
$553.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Senior Care Partners |
$101.90
|
| Rate for Payer: PACE SWMI |
$107.26
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$107.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$527.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.27
|
| Rate for Payer: Priority Health Medicare |
$107.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.68
|
| Rate for Payer: Railroad Medicare Medicare |
$107.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.56
|
| Rate for Payer: UHC Core |
$358.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.26
|
| Rate for Payer: UHC Medicare Advantage |
$110.48
|
| Rate for Payer: VA VA |
$107.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
36100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$261.68 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: BCBS Trust/PPO |
$331.57
|
| Rate for Payer: BCN Commercial |
$331.57
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.56
|
| Rate for Payer: UHC Core |
$358.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC AMNIOINFUSION
|
Facility
|
OP
|
$563.36
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
76100007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$133.80 |
| Max. Negotiated Rate |
$507.02 |
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna Medicare |
$146.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.05
|
| Rate for Payer: BCBS Complete |
$220.97
|
| Rate for Payer: BCBS MAPPO |
$140.84
|
| Rate for Payer: BCBS Trust/PPO |
$438.01
|
| Rate for Payer: BCN Commercial |
$438.01
|
| Rate for Payer: BCN Medicare Advantage |
$140.84
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$484.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.84
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.52
|
| Rate for Payer: Mclaren Medicaid |
$210.45
|
| Rate for Payer: Meridian Medicaid |
$220.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$478.86
|
| Rate for Payer: PACE Senior Care Partners |
$133.80
|
| Rate for Payer: PACE SWMI |
$140.84
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: PHP Medicare Advantage |
$140.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.12
|
| Rate for Payer: Priority Health Medicare |
$140.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.59
|
| Rate for Payer: Railroad Medicare Medicare |
$140.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.76
|
| Rate for Payer: UHC Core |
$470.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.84
|
| Rate for Payer: UHC Medicare Advantage |
$145.07
|
| Rate for Payer: VA VA |
$140.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.52
|
|
|
HC AMNIOINFUSION
|
Facility
|
IP
|
$563.36
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
76100007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$343.59 |
| Max. Negotiated Rate |
$507.02 |
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: BCBS Trust/PPO |
$435.36
|
| Rate for Payer: BCN Commercial |
$435.36
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$484.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.69
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$478.86
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.76
|
| Rate for Payer: UHC Core |
$470.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.52
|
|
|
HC AMNIOTIC FLUID DELTA OD
|
Facility
|
IP
|
$69.10
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
30100095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.14 |
| Max. Negotiated Rate |
$62.19 |
| Rate for Payer: Aetna Commercial |
$58.74
|
| Rate for Payer: BCBS Trust/PPO |
$53.40
|
| Rate for Payer: BCN Commercial |
$53.40
|
| Rate for Payer: Cash Price |
$55.28
|
| Rate for Payer: Cofinity Commercial |
$59.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.28
|
| Rate for Payer: Healthscope Commercial |
$62.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.74
|
| Rate for Payer: PHP Commercial |
$58.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.81
|
| Rate for Payer: UHC Core |
$57.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.82
|
|
|
HC AMNIOTIC FLUID DELTA OD
|
Facility
|
OP
|
$69.10
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
30100095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$62.19 |
| Rate for Payer: Aetna Commercial |
$58.74
|
| Rate for Payer: Aetna Medicare |
$17.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS MAPPO |
$17.28
|
| Rate for Payer: BCBS Trust/PPO |
$53.73
|
| Rate for Payer: BCN Commercial |
$53.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.28
|
| Rate for Payer: Cash Price |
$55.28
|
| Rate for Payer: Cash Price |
$55.28
|
| Rate for Payer: Cofinity Commercial |
$59.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.28
|
| Rate for Payer: Healthscope Commercial |
$62.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.82
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Meridian Medicaid |
$7.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.74
|
| Rate for Payer: PACE Senior Care Partners |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.28
|
| Rate for Payer: PHP Commercial |
$58.74
|
| Rate for Payer: PHP Medicare Advantage |
$17.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.12
|
| Rate for Payer: Priority Health Medicare |
$17.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.14
|
| Rate for Payer: Railroad Medicare Medicare |
$17.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.81
|
| Rate for Payer: UHC Core |
$57.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.28
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.82
|
|
|
HC AMNISURE ROM
|
Facility
|
IP
|
$203.49
|
|
|
Service Code
|
CPT 84112
|
| Hospital Charge Code |
30000009
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.11 |
| Max. Negotiated Rate |
$183.14 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: BCBS Trust/PPO |
$157.26
|
| Rate for Payer: BCN Commercial |
$157.26
|
| Rate for Payer: Cash Price |
$162.79
|
| Rate for Payer: Cofinity Commercial |
$175.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.79
|
| Rate for Payer: Healthscope Commercial |
$183.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.97
|
| Rate for Payer: PHP Commercial |
$172.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.07
|
| Rate for Payer: UHC Core |
$169.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.62
|
|
|
HC AMNISURE ROM
|
Facility
|
OP
|
$203.49
|
|
|
Service Code
|
CPT 84112
|
| Hospital Charge Code |
30000009
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$183.14 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$52.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.59
|
| Rate for Payer: BCBS Complete |
$76.03
|
| Rate for Payer: BCBS MAPPO |
$50.87
|
| Rate for Payer: BCBS Trust/PPO |
$158.21
|
| Rate for Payer: BCN Commercial |
$158.21
|
| Rate for Payer: BCN Medicare Advantage |
$50.87
|
| Rate for Payer: Cash Price |
$162.79
|
| Rate for Payer: Cash Price |
$162.79
|
| Rate for Payer: Cofinity Commercial |
$175.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.87
|
| Rate for Payer: Healthscope Commercial |
$183.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.62
|
| Rate for Payer: Mclaren Medicaid |
$72.41
|
| Rate for Payer: Meridian Medicaid |
$76.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.97
|
| Rate for Payer: PACE Senior Care Partners |
$48.33
|
| Rate for Payer: PACE SWMI |
$50.87
|
| Rate for Payer: PHP Commercial |
$172.97
|
| Rate for Payer: PHP Medicare Advantage |
$50.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.04
|
| Rate for Payer: Priority Health Medicare |
$50.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.11
|
| Rate for Payer: Railroad Medicare Medicare |
$50.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.07
|
| Rate for Payer: UHC Core |
$169.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.87
|
| Rate for Payer: UHC Medicare Advantage |
$52.40
|
| Rate for Payer: VA VA |
$50.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.62
|
|
|
HC AMPA-R AB CBA, SERUM
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200416
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$304.95 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$425.00
|
| Rate for Payer: BCBS Trust/PPO |
$386.40
|
| Rate for Payer: BCN Commercial |
$386.40
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$430.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.00
|
| Rate for Payer: PHP Commercial |
$425.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.00
|
| Rate for Payer: UHC Core |
$417.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.00
|
|
|
HC AMPA-R AB CBA, SERUM
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200416
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$425.00
|
| Rate for Payer: Aetna Medicare |
$130.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.25
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$125.00
|
| Rate for Payer: BCBS Trust/PPO |
$388.75
|
| Rate for Payer: BCN Commercial |
$388.75
|
| Rate for Payer: BCN Medicare Advantage |
$125.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$430.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.00
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.00
|
| Rate for Payer: PACE Senior Care Partners |
$118.75
|
| Rate for Payer: PACE SWMI |
$125.00
|
| Rate for Payer: PHP Commercial |
$425.00
|
| Rate for Payer: PHP Medicare Advantage |
$125.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.00
|
| Rate for Payer: Priority Health Medicare |
$125.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.95
|
| Rate for Payer: Railroad Medicare Medicare |
$125.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.00
|
| Rate for Payer: UHC Core |
$417.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.00
|
| Rate for Payer: UHC Medicare Advantage |
$128.75
|
| Rate for Payer: VA VA |
$125.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.00
|
|
|
HC AMPA-R AB IF TITER ASSAY, S
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200417
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC AMPA-R AB IF TITER ASSAY, S
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200417
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC AMP FINGER/THUMB W DIRECT CLOSURE
|
Facility
|
OP
|
$4,492.58
|
|
|
Service Code
|
CPT 26951
|
| Hospital Charge Code |
45000090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,066.99 |
| Max. Negotiated Rate |
$4,043.32 |
| Rate for Payer: Aetna Commercial |
$3,818.69
|
| Rate for Payer: Aetna Medicare |
$1,168.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,403.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,403.93
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$1,123.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,492.98
|
| Rate for Payer: BCN Commercial |
$3,492.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,123.14
|
| Rate for Payer: Cash Price |
$3,594.06
|
| Rate for Payer: Cash Price |
$3,594.06
|
| Rate for Payer: Cofinity Commercial |
$3,863.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,594.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,123.14
|
| Rate for Payer: Healthscope Commercial |
$4,043.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,369.44
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,179.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,291.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,818.69
|
| Rate for Payer: PACE Senior Care Partners |
$1,066.99
|
| Rate for Payer: PACE SWMI |
$1,123.14
|
| Rate for Payer: PHP Commercial |
$3,818.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,123.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,144.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,908.54
|
| Rate for Payer: Priority Health Medicare |
$1,123.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,740.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,123.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,953.47
|
| Rate for Payer: UHC Core |
$3,751.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,123.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,156.84
|
| Rate for Payer: VA VA |
$1,123.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,369.44
|
|
|
HC AMP FINGER/THUMB W DIRECT CLOSURE
|
Facility
|
IP
|
$4,492.58
|
|
|
Service Code
|
CPT 26951
|
| Hospital Charge Code |
45000090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,740.02 |
| Max. Negotiated Rate |
$4,043.32 |
| Rate for Payer: Aetna Commercial |
$3,818.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,471.87
|
| Rate for Payer: BCN Commercial |
$3,471.87
|
| Rate for Payer: Cash Price |
$3,594.06
|
| Rate for Payer: Cofinity Commercial |
$3,863.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,594.06
|
| Rate for Payer: Healthscope Commercial |
$4,043.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,369.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,818.69
|
| Rate for Payer: PHP Commercial |
$3,818.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,144.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,908.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,740.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,953.47
|
| Rate for Payer: UHC Core |
$3,751.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,369.44
|
|
