|
HC ANOSCOPY WITH DILATION
|
Facility
|
OP
|
$2,033.68
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$1,830.31 |
| Rate for Payer: Aetna Commercial |
$1,728.63
|
| Rate for Payer: Aetna Medicare |
$528.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$635.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$635.52
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$508.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,581.19
|
| Rate for Payer: BCN Commercial |
$1,581.19
|
| Rate for Payer: BCN Medicare Advantage |
$508.42
|
| Rate for Payer: Cash Price |
$1,626.94
|
| Rate for Payer: Cash Price |
$1,626.94
|
| Rate for Payer: Cofinity Commercial |
$1,748.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,626.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.42
|
| Rate for Payer: Healthscope Commercial |
$1,830.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,525.26
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$533.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$584.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,728.63
|
| Rate for Payer: PACE Senior Care Partners |
$483.00
|
| Rate for Payer: PACE SWMI |
$508.42
|
| Rate for Payer: PHP Commercial |
$1,728.63
|
| Rate for Payer: PHP Medicare Advantage |
$508.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,769.30
|
| Rate for Payer: Priority Health Medicare |
$508.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,240.34
|
| Rate for Payer: Railroad Medicare Medicare |
$508.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,789.64
|
| Rate for Payer: UHC Core |
$1,698.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.42
|
| Rate for Payer: UHC Medicare Advantage |
$523.67
|
| Rate for Payer: VA VA |
$508.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,525.26
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$70.44 |
| Max. Negotiated Rate |
$103.95 |
| Rate for Payer: Aetna Commercial |
$98.18
|
| Rate for Payer: BCBS Trust/PPO |
$89.26
|
| Rate for Payer: BCN Commercial |
$89.26
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.40
|
| Rate for Payer: Healthscope Commercial |
$103.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.18
|
| Rate for Payer: PHP Commercial |
$98.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.64
|
| Rate for Payer: UHC Core |
$96.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.62
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$27.43 |
| Max. Negotiated Rate |
$103.95 |
| Rate for Payer: Aetna Commercial |
$98.18
|
| Rate for Payer: Aetna Medicare |
$30.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.09
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCBS Trust/PPO |
$89.80
|
| Rate for Payer: BCN Commercial |
$89.80
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$103.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.62
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.18
|
| Rate for Payer: PACE Senior Care Partners |
$27.43
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Commercial |
$98.18
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.48
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.44
|
| Rate for Payer: Railroad Medicare Medicare |
$28.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.64
|
| Rate for Payer: UHC Core |
$96.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$29.74
|
| Rate for Payer: VA VA |
$28.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.62
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| 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 ANTIBODY ECHOVIRUS
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.33 |
| 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 |
$10.10
|
| 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 |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| 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 |
$9.62
|
| 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 ANTIBODY ECHOVIRUS CMPT
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| 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 ANTIBODY ECHOVIRUS CMPT
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.33 |
| 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 |
$10.10
|
| 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 |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| 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 |
$9.62
|
| 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 ANTIBODY ELUTION
|
Facility
|
IP
|
$293.90
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$179.25 |
| Max. Negotiated Rate |
$264.51 |
| Rate for Payer: Aetna Commercial |
$249.82
|
| Rate for Payer: BCBS Trust/PPO |
$227.13
|
| Rate for Payer: BCN Commercial |
$227.13
|
| Rate for Payer: Cash Price |
$235.12
|
| Rate for Payer: Cofinity Commercial |
$252.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.12
|
| Rate for Payer: Healthscope Commercial |
$264.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.82
|
| Rate for Payer: PHP Commercial |
$249.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.63
|
| Rate for Payer: UHC Core |
$245.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.42
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
OP
|
$293.90
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$264.51 |
| Rate for Payer: Aetna Commercial |
$249.82
|
| Rate for Payer: Aetna Medicare |
$76.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.84
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$73.48
|
| Rate for Payer: BCBS Trust/PPO |
$228.51
|
| Rate for Payer: BCN Commercial |
$228.51
|
| Rate for Payer: BCN Medicare Advantage |
$73.48
|
| Rate for Payer: Cash Price |
$235.12
|
| Rate for Payer: Cash Price |
$235.12
|
| Rate for Payer: Cofinity Commercial |
$252.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.48
|
| Rate for Payer: Healthscope Commercial |
$264.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.42
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.82
|
| Rate for Payer: PACE Senior Care Partners |
$69.80
|
| Rate for Payer: PACE SWMI |
$73.48
|
| Rate for Payer: PHP Commercial |
$249.82
|
| Rate for Payer: PHP Medicare Advantage |
$73.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.69
|
| Rate for Payer: Priority Health Medicare |
$73.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.25
|
| Rate for Payer: Railroad Medicare Medicare |
$73.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.63
|
| Rate for Payer: UHC Core |
$245.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.48
|
| Rate for Payer: UHC Medicare Advantage |
$75.68
|
| Rate for Payer: VA VA |
$73.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.42
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$209.10
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.66 |
| Max. Negotiated Rate |
$247.59 |
| 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 |
$247.59
|
| 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 |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| 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 |
$235.80
|
| 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 ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$209.10
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| 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
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
IP
|
$92.00
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.11 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Aetna Commercial |
$78.20
|
| Rate for Payer: BCBS Trust/PPO |
$71.10
|
| Rate for Payer: BCN Commercial |
$71.10
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$79.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.60
|
| Rate for Payer: Healthscope Commercial |
$82.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.20
|
| Rate for Payer: PHP Commercial |
$78.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.96
|
| Rate for Payer: UHC Core |
$76.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.00
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Aetna Commercial |
$78.20
|
| Rate for Payer: Aetna Medicare |
$23.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.75
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$23.00
|
| Rate for Payer: BCBS Trust/PPO |
$71.53
|
| Rate for Payer: BCN Commercial |
$71.53
|
| Rate for Payer: BCN Medicare Advantage |
$23.00
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$79.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.00
|
| Rate for Payer: Healthscope Commercial |
$82.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.00
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.20
|
| Rate for Payer: PACE Senior Care Partners |
$21.85
|
| Rate for Payer: PACE SWMI |
$23.00
|
| Rate for Payer: PHP Commercial |
$78.20
|
| Rate for Payer: PHP Medicare Advantage |
$23.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.04
|
| Rate for Payer: Priority Health Medicare |
$23.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.11
|
| Rate for Payer: Railroad Medicare Medicare |
$23.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.96
|
| Rate for Payer: UHC Core |
$76.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.00
|
| Rate for Payer: UHC Medicare Advantage |
$23.69
|
| Rate for Payer: VA VA |
$23.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.00
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.69
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
IP
|
$33.66
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$30.29 |
| Rate for Payer: Aetna Commercial |
$28.61
|
| Rate for Payer: BCBS Trust/PPO |
$26.01
|
| Rate for Payer: BCN Commercial |
$26.01
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$28.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.61
|
| Rate for Payer: PHP Commercial |
$28.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.62
|
| Rate for Payer: UHC Core |
$28.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.24
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
OP
|
$33.66
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.99 |
| Max. Negotiated Rate |
$30.29 |
| Rate for Payer: Aetna Commercial |
$28.61
|
| Rate for Payer: Aetna Medicare |
$8.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.52
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$8.42
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$8.42
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$28.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.42
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.24
|
| Rate for Payer: Mclaren Medicaid |
$11.43
|
| Rate for Payer: Meridian Medicaid |
$12.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.61
|
| Rate for Payer: PACE Senior Care Partners |
$7.99
|
| Rate for Payer: PACE SWMI |
$8.42
|
| Rate for Payer: PHP Commercial |
$28.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.28
|
| Rate for Payer: Priority Health Medicare |
$8.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.62
|
| Rate for Payer: UHC Core |
$28.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$8.67
|
| Rate for Payer: VA VA |
$8.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.24
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
IP
|
$65.28
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.81 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: BCBS Trust/PPO |
$50.45
|
| Rate for Payer: BCN Commercial |
$50.45
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.49
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.45
|
| Rate for Payer: UHC Core |
$54.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.96
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
OP
|
$65.28
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: Aetna Medicare |
$16.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.40
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$16.32
|
| Rate for Payer: BCBS Trust/PPO |
$50.76
|
| Rate for Payer: BCN Commercial |
$50.76
|
| Rate for Payer: BCN Medicare Advantage |
$16.32
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.96
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.49
|
| Rate for Payer: PACE Senior Care Partners |
$15.50
|
| Rate for Payer: PACE SWMI |
$16.32
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.79
|
| Rate for Payer: Priority Health Medicare |
$16.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.81
|
| Rate for Payer: Railroad Medicare Medicare |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.45
|
| Rate for Payer: UHC Core |
$54.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$16.81
|
| Rate for Payer: VA VA |
$16.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.96
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
OP
|
$83.90
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$75.51 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Medicare |
$21.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.22
|
| Rate for Payer: BCBS Complete |
$12.33
|
| Rate for Payer: BCBS MAPPO |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: BCN Medicare Advantage |
$20.98
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.98
|
| Rate for Payer: Healthscope Commercial |
$75.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.92
|
| Rate for Payer: Mclaren Medicaid |
$11.74
|
| Rate for Payer: Meridian Medicaid |
$12.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.32
|
| Rate for Payer: PACE Senior Care Partners |
$19.93
|
| Rate for Payer: PACE SWMI |
$20.98
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: PHP Medicare Advantage |
$20.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.99
|
| Rate for Payer: Priority Health Medicare |
$20.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.17
|
| Rate for Payer: Railroad Medicare Medicare |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.83
|
| Rate for Payer: UHC Core |
$70.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$21.60
|
| Rate for Payer: VA VA |
$20.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.92
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
IP
|
$83.90
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.17 |
| Max. Negotiated Rate |
$75.51 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: BCBS Trust/PPO |
$64.84
|
| Rate for Payer: BCN Commercial |
$64.84
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.12
|
| Rate for Payer: Healthscope Commercial |
$75.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.32
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.83
|
| Rate for Payer: UHC Core |
$70.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.92
|
|
