|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.74 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Aetna Commercial |
$102.85
|
| Rate for Payer: Aetna Medicare |
$31.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.81
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS MAPPO |
$30.25
|
| Rate for Payer: BCBS Trust/PPO |
$94.08
|
| Rate for Payer: BCN Commercial |
$94.08
|
| Rate for Payer: BCN Medicare Advantage |
$30.25
|
| 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: Health Alliance Plan Medicare Advantage |
$30.25
|
| Rate for Payer: Healthscope Commercial |
$108.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.85
|
| Rate for Payer: PACE Senior Care Partners |
$28.74
|
| Rate for Payer: PACE SWMI |
$30.25
|
| Rate for Payer: PHP Commercial |
$102.85
|
| Rate for Payer: PHP Medicare Advantage |
$30.25
|
| 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 Medicare |
$30.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.80
|
| Rate for Payer: Railroad Medicare Medicare |
$30.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.48
|
| Rate for Payer: UHC Core |
$101.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.25
|
| Rate for Payer: UHC Medicare Advantage |
$31.16
|
| Rate for Payer: VA VA |
$30.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.75
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$70.69
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.11 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: BCBS Trust/PPO |
$54.63
|
| Rate for Payer: BCN Commercial |
$54.63
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.21
|
| Rate for Payer: UHC Core |
$59.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$70.69
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: Aetna Medicare |
$18.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.09
|
| Rate for Payer: BCBS Complete |
$10.65
|
| Rate for Payer: BCBS MAPPO |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$54.96
|
| Rate for Payer: BCN Commercial |
$54.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.67
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.67
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Mclaren Medicaid |
$10.14
|
| Rate for Payer: Meridian Medicaid |
$10.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: PACE Senior Care Partners |
$16.79
|
| Rate for Payer: PACE SWMI |
$17.67
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.50
|
| Rate for Payer: Priority Health Medicare |
$17.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.11
|
| Rate for Payer: Railroad Medicare Medicare |
$17.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.21
|
| Rate for Payer: UHC Core |
$59.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.67
|
| Rate for Payer: UHC Medicare Advantage |
$18.20
|
| Rate for Payer: VA VA |
$17.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$70.69
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: Aetna Medicare |
$18.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.09
|
| Rate for Payer: BCBS Complete |
$9.37
|
| Rate for Payer: BCBS MAPPO |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$54.96
|
| Rate for Payer: BCN Commercial |
$54.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.67
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.67
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Mclaren Medicaid |
$8.92
|
| Rate for Payer: Meridian Medicaid |
$9.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: PACE Senior Care Partners |
$16.79
|
| Rate for Payer: PACE SWMI |
$17.67
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.50
|
| Rate for Payer: Priority Health Medicare |
$17.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.11
|
| Rate for Payer: Railroad Medicare Medicare |
$17.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.21
|
| Rate for Payer: UHC Core |
$59.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.67
|
| Rate for Payer: UHC Medicare Advantage |
$18.20
|
| Rate for Payer: VA VA |
$17.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$70.69
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.11 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: BCBS Trust/PPO |
$54.63
|
| Rate for Payer: BCN Commercial |
$54.63
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.21
|
| Rate for Payer: UHC Core |
$59.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
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 ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.92 |
| 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 |
$9.37
|
| 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 |
$8.92
|
| Rate for Payer: Meridian Medicaid |
$9.37
|
| 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 |
$8.92
|
| 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 ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$8.65
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$8.24
|
| Rate for Payer: Meridian Medicaid |
$8.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.47 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$57.80
|
| Rate for Payer: BCBS Trust/PPO |
$52.55
|
| Rate for Payer: BCN Commercial |
$52.55
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PHP Commercial |
$57.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Core |
$56.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.00
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$57.80
|
| Rate for Payer: Aetna Medicare |
$17.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.25
|
| Rate for Payer: BCBS Complete |
$5.66
|
| Rate for Payer: BCBS MAPPO |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$52.87
|
| Rate for Payer: BCN Commercial |
$52.87
|
| Rate for Payer: BCN Medicare Advantage |
$17.00
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.00
|
| Rate for Payer: Mclaren Medicaid |
$5.39
|
| Rate for Payer: Meridian Medicaid |
$5.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PACE Senior Care Partners |
$16.15
|
| Rate for Payer: PACE SWMI |
$17.00
|
| Rate for Payer: PHP Commercial |
$57.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.16
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.47
|
| Rate for Payer: Railroad Medicare Medicare |
$17.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Core |
$56.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$17.51
|
| Rate for Payer: VA VA |
$17.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.00
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.75 |
| 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 |
$9.18
|
| 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 |
$8.75
|
| Rate for Payer: Meridian Medicaid |
$9.18
|
| 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 |
$8.75
|
| 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 ANTI THROMBIN III
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| 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 ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$15.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.75
|
| Rate for Payer: BCBS Complete |
$8.38
|
| Rate for Payer: BCBS MAPPO |
$15.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.65
|
| Rate for Payer: BCN Commercial |
$46.65
|
| Rate for Payer: BCN Medicare Advantage |
$15.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Mclaren Medicaid |
$7.98
|
| Rate for Payer: Meridian Medicaid |
$8.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Senior Care Partners |
$14.25
|
| Rate for Payer: PACE SWMI |
$15.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$15.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Medicare |
$15.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.45
|
| Rate for Payer: VA VA |
$15.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$36.59 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.37
|
| Rate for Payer: BCN Commercial |
$46.37
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$33.82
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$32.21
|
| Rate for Payer: Meridian Medicaid |
$33.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
IP
|
$717.35
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$437.51 |
| Max. Negotiated Rate |
$645.62 |
| Rate for Payer: Aetna Commercial |
$609.75
|
| Rate for Payer: BCBS Trust/PPO |
$554.37
|
| Rate for Payer: BCN Commercial |
$554.37
|
| Rate for Payer: Cash Price |
$573.88
|
| Rate for Payer: Cofinity Commercial |
$616.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$573.88
|
| Rate for Payer: Healthscope Commercial |
$645.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$538.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$609.75
|
| Rate for Payer: PHP Commercial |
$609.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$437.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.27
|
| Rate for Payer: UHC Core |
$598.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$538.01
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
OP
|
$717.35
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$170.37 |
| Max. Negotiated Rate |
$645.62 |
| Rate for Payer: Aetna Commercial |
$609.75
|
| Rate for Payer: Aetna Medicare |
$186.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.17
|
| Rate for Payer: BCBS Complete |
$286.94
|
| Rate for Payer: BCBS MAPPO |
$179.34
|
| Rate for Payer: BCBS Trust/PPO |
$557.74
|
| Rate for Payer: BCN Commercial |
$557.74
|
| Rate for Payer: BCN Medicare Advantage |
$179.34
|
| Rate for Payer: Cash Price |
$573.88
|
| Rate for Payer: Cofinity Commercial |
$616.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$573.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.34
|
| Rate for Payer: Healthscope Commercial |
$645.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$538.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$609.75
|
| Rate for Payer: PACE Senior Care Partners |
$170.37
|
| Rate for Payer: PACE SWMI |
$179.34
|
| Rate for Payer: PHP Commercial |
$609.75
|
| Rate for Payer: PHP Medicare Advantage |
$179.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.09
|
| Rate for Payer: Priority Health Medicare |
$179.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$437.51
|
| Rate for Payer: Railroad Medicare Medicare |
$179.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.27
|
| Rate for Payer: UHC Core |
$598.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.34
|
| Rate for Payer: UHC Medicare Advantage |
$184.72
|
| Rate for Payer: VA VA |
$179.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$538.01
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,294.92
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$789.77 |
| Max. Negotiated Rate |
$1,165.43 |
| Rate for Payer: Aetna Commercial |
$1,100.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.71
|
| Rate for Payer: BCN Commercial |
$1,000.71
|
| Rate for Payer: Cash Price |
$1,035.94
|
| Rate for Payer: Cofinity Commercial |
$1,113.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.94
|
| Rate for Payer: Healthscope Commercial |
$1,165.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$971.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,100.68
|
| Rate for Payer: PHP Commercial |
$1,100.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,126.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$789.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,139.53
|
| Rate for Payer: UHC Core |
$1,081.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$971.19
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
OP
|
$1,294.92
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,165.43 |
| Rate for Payer: Aetna Commercial |
$1,100.68
|
| Rate for Payer: Aetna Medicare |
$336.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.66
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$323.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.80
|
| Rate for Payer: BCN Commercial |
$1,006.80
|
| Rate for Payer: BCN Medicare Advantage |
$323.73
|
| Rate for Payer: Cash Price |
$1,035.94
|
| Rate for Payer: Cash Price |
$1,035.94
|
| Rate for Payer: Cofinity Commercial |
$1,113.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.73
|
| Rate for Payer: Healthscope Commercial |
$1,165.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$971.19
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$339.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,100.68
|
| Rate for Payer: PACE Senior Care Partners |
$307.54
|
| Rate for Payer: PACE SWMI |
$323.73
|
| Rate for Payer: PHP Commercial |
$1,100.68
|
| Rate for Payer: PHP Medicare Advantage |
$323.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,126.58
|
| Rate for Payer: Priority Health Medicare |
$323.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$789.77
|
| Rate for Payer: Railroad Medicare Medicare |
$323.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,139.53
|
| Rate for Payer: UHC Core |
$1,081.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.73
|
| Rate for Payer: UHC Medicare Advantage |
$333.44
|
| Rate for Payer: VA VA |
$323.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$971.19
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| 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 |
$75.72
|
| 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 |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| 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 |
$72.12
|
| 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 AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| 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
|
|
