|
HC ANTIBODY TITER
|
Facility
|
IP
|
$266.60
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$239.94 |
| Rate for Payer: Aetna Commercial |
$226.61
|
| Rate for Payer: BCBS Trust/PPO |
$206.03
|
| Rate for Payer: BCN Commercial |
$206.03
|
| Rate for Payer: Cash Price |
$213.28
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.28
|
| Rate for Payer: Healthscope Commercial |
$239.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.61
|
| Rate for Payer: PHP Commercial |
$226.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.61
|
| Rate for Payer: UHC Core |
$222.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.95
|
|
|
HC ANTIBODY TITER
|
Facility
|
OP
|
$266.60
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.32 |
| Max. Negotiated Rate |
$239.94 |
| Rate for Payer: Aetna Commercial |
$226.61
|
| Rate for Payer: Aetna Medicare |
$69.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.31
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$66.65
|
| Rate for Payer: BCBS Trust/PPO |
$207.28
|
| Rate for Payer: BCN Commercial |
$207.28
|
| Rate for Payer: BCN Medicare Advantage |
$66.65
|
| Rate for Payer: Cash Price |
$213.28
|
| Rate for Payer: Cash Price |
$213.28
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.65
|
| Rate for Payer: Healthscope Commercial |
$239.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.95
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.61
|
| Rate for Payer: PACE Senior Care Partners |
$63.32
|
| Rate for Payer: PACE SWMI |
$66.65
|
| Rate for Payer: PHP Commercial |
$226.61
|
| Rate for Payer: PHP Medicare Advantage |
$66.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.94
|
| Rate for Payer: Priority Health Medicare |
$66.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.60
|
| Rate for Payer: Railroad Medicare Medicare |
$66.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.61
|
| Rate for Payer: UHC Core |
$222.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.65
|
| Rate for Payer: UHC Medicare Advantage |
$68.65
|
| Rate for Payer: VA VA |
$66.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.95
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
IP
|
$55.59
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$50.03 |
| Rate for Payer: Aetna Commercial |
$47.25
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| Rate for Payer: Cash Price |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$47.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.47
|
| Rate for Payer: Healthscope Commercial |
$50.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.25
|
| Rate for Payer: PHP Commercial |
$47.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.92
|
| Rate for Payer: UHC Core |
$46.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.69
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
OP
|
$55.59
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$50.03 |
| Rate for Payer: Aetna Commercial |
$47.25
|
| Rate for Payer: Aetna Medicare |
$14.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.37
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$13.90
|
| Rate for Payer: BCBS Trust/PPO |
$43.22
|
| Rate for Payer: BCN Commercial |
$43.22
|
| Rate for Payer: BCN Medicare Advantage |
$13.90
|
| Rate for Payer: Cash Price |
$44.47
|
| Rate for Payer: Cash Price |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$47.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.90
|
| Rate for Payer: Healthscope Commercial |
$50.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.69
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.25
|
| Rate for Payer: PACE Senior Care Partners |
$13.20
|
| Rate for Payer: PACE SWMI |
$13.90
|
| Rate for Payer: PHP Commercial |
$47.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.36
|
| Rate for Payer: Priority Health Medicare |
$13.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.92
|
| Rate for Payer: UHC Core |
$46.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.90
|
| Rate for Payer: UHC Medicare Advantage |
$14.31
|
| Rate for Payer: VA VA |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.69
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
OP
|
$55.59
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$50.03 |
| Rate for Payer: Aetna Commercial |
$47.25
|
| Rate for Payer: Aetna Medicare |
$14.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.37
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$13.90
|
| Rate for Payer: BCBS Trust/PPO |
$43.22
|
| Rate for Payer: BCN Commercial |
$43.22
|
| Rate for Payer: BCN Medicare Advantage |
$13.90
|
| Rate for Payer: Cash Price |
$44.47
|
| Rate for Payer: Cash Price |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$47.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.90
|
| Rate for Payer: Healthscope Commercial |
$50.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.69
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.25
|
| Rate for Payer: PACE Senior Care Partners |
$13.20
|
| Rate for Payer: PACE SWMI |
$13.90
|
| Rate for Payer: PHP Commercial |
$47.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.36
|
| Rate for Payer: Priority Health Medicare |
$13.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.92
|
| Rate for Payer: UHC Core |
$46.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.90
|
| Rate for Payer: UHC Medicare Advantage |
$14.31
|
| Rate for Payer: VA VA |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.69
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
IP
|
$55.59
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$50.03 |
| Rate for Payer: Aetna Commercial |
$47.25
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| Rate for Payer: Cash Price |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$47.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.47
|
| Rate for Payer: Healthscope Commercial |
$50.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.25
|
| Rate for Payer: PHP Commercial |
$47.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.92
|
| Rate for Payer: UHC Core |
$46.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.69
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
OP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$163.93 |
| Rate for Payer: Aetna Commercial |
$154.82
|
| Rate for Payer: Aetna Medicare |
$47.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.92
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$45.54
|
| Rate for Payer: BCBS Trust/PPO |
$141.61
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$141.61
|
| Rate for Payer: BCN Medicare Advantage |
$45.54
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$156.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.54
|
| Rate for Payer: Healthscope Commercial |
$163.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$154.82
|
| Rate for Payer: PACE Senior Care Partners |
$43.26
|
| Rate for Payer: PACE SWMI |
$45.54
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: PHP Medicare Advantage |
$45.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.46
|
| Rate for Payer: Priority Health Medicare |
$45.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.09
|
| Rate for Payer: Railroad Medicare Medicare |
$45.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.54
|
| Rate for Payer: UHC Medicare Advantage |
$46.90
|
| Rate for Payer: VA VA |
$45.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
IP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.09 |
| Max. Negotiated Rate |
$163.93 |
| Rate for Payer: Aetna Commercial |
$154.82
|
| Rate for Payer: BCBS Trust/PPO |
$140.76
|
| Rate for Payer: BCN Commercial |
$140.76
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$156.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Healthscope Commercial |
$163.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$154.82
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: BCBS Trust/PPO |
$53.60
|
| Rate for Payer: BCN Commercial |
$53.60
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$18.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: BCBS Complete |
$26.30
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$53.93
|
| Rate for Payer: BCN Commercial |
$53.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$25.05
|
| Rate for Payer: Meridian Medicaid |
$26.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PACE Senior Care Partners |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.34
|
| Rate for Payer: UHC Medicare Advantage |
$17.86
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
IP
|
$72.42
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$65.18 |
| Rate for Payer: Aetna Commercial |
$61.56
|
| Rate for Payer: BCBS Trust/PPO |
$55.97
|
| Rate for Payer: BCN Commercial |
$55.97
|
| Rate for Payer: Cash Price |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.94
|
| Rate for Payer: Healthscope Commercial |
$65.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.56
|
| Rate for Payer: PHP Commercial |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.73
|
| Rate for Payer: UHC Core |
$60.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.32
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
OP
|
$72.42
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$65.18 |
| Rate for Payer: Aetna Commercial |
$61.56
|
| Rate for Payer: Aetna Medicare |
$18.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.63
|
| Rate for Payer: BCBS Complete |
$28.97
|
| Rate for Payer: BCBS MAPPO |
$18.10
|
| Rate for Payer: BCBS Trust/PPO |
$56.31
|
| Rate for Payer: BCN Commercial |
$56.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.10
|
| Rate for Payer: Cash Price |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.10
|
| Rate for Payer: Healthscope Commercial |
$65.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.56
|
| Rate for Payer: PACE Senior Care Partners |
$17.20
|
| Rate for Payer: PACE SWMI |
$18.10
|
| Rate for Payer: PHP Commercial |
$61.56
|
| Rate for Payer: PHP Medicare Advantage |
$18.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.01
|
| Rate for Payer: Priority Health Medicare |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: Railroad Medicare Medicare |
$18.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.73
|
| Rate for Payer: UHC Core |
$60.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.10
|
| Rate for Payer: UHC Medicare Advantage |
$18.65
|
| Rate for Payer: VA VA |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.32
|
|
|
HC ANTI FACTOR XA
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$10.14
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$9.66
|
| Rate for Payer: Meridian Medicaid |
$10.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ANTI FACTOR XA
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
OP
|
$111.59
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: Aetna Medicare |
$29.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.87
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$27.90
|
| Rate for Payer: BCBS Trust/PPO |
$86.76
|
| Rate for Payer: BCN Commercial |
$86.76
|
| Rate for Payer: BCN Medicare Advantage |
$27.90
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.90
|
| Rate for Payer: Healthscope Commercial |
$100.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.69
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.85
|
| Rate for Payer: PACE Senior Care Partners |
$26.50
|
| Rate for Payer: PACE SWMI |
$27.90
|
| Rate for Payer: PHP Commercial |
$94.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.08
|
| Rate for Payer: Priority Health Medicare |
$27.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.06
|
| Rate for Payer: Railroad Medicare Medicare |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.20
|
| Rate for Payer: UHC Core |
$93.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.90
|
| Rate for Payer: UHC Medicare Advantage |
$28.73
|
| Rate for Payer: VA VA |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.69
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
IP
|
$111.59
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.06 |
| Max. Negotiated Rate |
$100.43 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: BCBS Trust/PPO |
$86.24
|
| Rate for Payer: BCN Commercial |
$86.24
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.27
|
| Rate for Payer: Healthscope Commercial |
$100.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.85
|
| Rate for Payer: PHP Commercial |
$94.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.20
|
| Rate for Payer: UHC Core |
$93.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.69
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
IP
|
$111.59
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.06 |
| Max. Negotiated Rate |
$100.43 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: BCBS Trust/PPO |
$86.24
|
| Rate for Payer: BCN Commercial |
$86.24
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.27
|
| Rate for Payer: Healthscope Commercial |
$100.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.85
|
| Rate for Payer: PHP Commercial |
$94.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.20
|
| Rate for Payer: UHC Core |
$93.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.69
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
OP
|
$111.59
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: Aetna Medicare |
$29.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.87
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$27.90
|
| Rate for Payer: BCBS Trust/PPO |
$86.76
|
| Rate for Payer: BCN Commercial |
$86.76
|
| Rate for Payer: BCN Medicare Advantage |
$27.90
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.90
|
| Rate for Payer: Healthscope Commercial |
$100.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.69
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.85
|
| Rate for Payer: PACE Senior Care Partners |
$26.50
|
| Rate for Payer: PACE SWMI |
$27.90
|
| Rate for Payer: PHP Commercial |
$94.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.08
|
| Rate for Payer: Priority Health Medicare |
$27.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.06
|
| Rate for Payer: Railroad Medicare Medicare |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.20
|
| Rate for Payer: UHC Core |
$93.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.90
|
| Rate for Payer: UHC Medicare Advantage |
$28.73
|
| Rate for Payer: VA VA |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.69
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
IP
|
$111.59
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.06 |
| Max. Negotiated Rate |
$100.43 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: BCBS Trust/PPO |
$86.24
|
| Rate for Payer: BCN Commercial |
$86.24
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.27
|
| Rate for Payer: Healthscope Commercial |
$100.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.85
|
| Rate for Payer: PHP Commercial |
$94.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.20
|
| Rate for Payer: UHC Core |
$93.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.69
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
OP
|
$111.59
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$94.85
|
| Rate for Payer: Aetna Medicare |
$29.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.87
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$27.90
|
| Rate for Payer: BCBS Trust/PPO |
$86.76
|
| Rate for Payer: BCN Commercial |
$86.76
|
| Rate for Payer: BCN Medicare Advantage |
$27.90
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cash Price |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.90
|
| Rate for Payer: Healthscope Commercial |
$100.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.69
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.85
|
| Rate for Payer: PACE Senior Care Partners |
$26.50
|
| Rate for Payer: PACE SWMI |
$27.90
|
| Rate for Payer: PHP Commercial |
$94.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.08
|
| Rate for Payer: Priority Health Medicare |
$27.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.06
|
| Rate for Payer: Railroad Medicare Medicare |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.20
|
| Rate for Payer: UHC Core |
$93.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.90
|
| Rate for Payer: UHC Medicare Advantage |
$28.73
|
| Rate for Payer: VA VA |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.69
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.22 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: BCBS Trust/PPO |
$43.35
|
| Rate for Payer: BCN Commercial |
$43.35
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.53
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$14.02
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$14.02
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PACE Senior Care Partners |
$13.32
|
| Rate for Payer: PACE SWMI |
$14.02
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.81
|
| Rate for Payer: Priority Health Medicare |
$14.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.02
|
| Rate for Payer: UHC Medicare Advantage |
$14.45
|
| Rate for Payer: VA VA |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$28.38
|
| Rate for Payer: BCN Commercial |
$28.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.48
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.55
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Aetna Commercial |
$102.85
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$93.51
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$104.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.80
|
| Rate for Payer: Healthscope Commercial |
$108.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.85
|
| Rate for Payer: PHP Commercial |
$102.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.48
|
| Rate for Payer: UHC Core |
$101.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.75
|
|
