|
HC BENIGN HYPERKERATOTIC >4 LESIONS
|
Facility
|
IP
|
$272.49
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
76100040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$245.24 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: BCBS Trust/PPO |
$210.58
|
| Rate for Payer: BCN Commercial |
$210.58
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.99
|
| Rate for Payer: Healthscope Commercial |
$245.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.62
|
| Rate for Payer: PHP Commercial |
$231.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.79
|
| Rate for Payer: UHC Core |
$227.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.37
|
|
|
HC BENIGN HYPERKERATOTIC >4 LESIONS
|
Facility
|
OP
|
$272.49
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
76100040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.72 |
| Max. Negotiated Rate |
$245.24 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: Aetna Medicare |
$70.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.15
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$68.12
|
| Rate for Payer: BCBS Trust/PPO |
$211.86
|
| Rate for Payer: BCN Commercial |
$211.86
|
| Rate for Payer: BCN Medicare Advantage |
$68.12
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.12
|
| Rate for Payer: Healthscope Commercial |
$245.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.37
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.62
|
| Rate for Payer: PACE Senior Care Partners |
$64.72
|
| Rate for Payer: PACE SWMI |
$68.12
|
| Rate for Payer: PHP Commercial |
$231.62
|
| Rate for Payer: PHP Medicare Advantage |
$68.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.07
|
| Rate for Payer: Priority Health Medicare |
$68.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.19
|
| Rate for Payer: Railroad Medicare Medicare |
$68.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.79
|
| Rate for Payer: UHC Core |
$227.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.12
|
| Rate for Payer: UHC Medicare Advantage |
$70.17
|
| Rate for Payer: VA VA |
$68.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.37
|
|
|
HC BENIGN HYPERKERATOTIC LESION
|
Facility
|
OP
|
$272.49
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
76100041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.72 |
| Max. Negotiated Rate |
$245.24 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: Aetna Medicare |
$70.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.15
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$68.12
|
| Rate for Payer: BCBS Trust/PPO |
$211.86
|
| Rate for Payer: BCN Commercial |
$211.86
|
| Rate for Payer: BCN Medicare Advantage |
$68.12
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.12
|
| Rate for Payer: Healthscope Commercial |
$245.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.37
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.62
|
| Rate for Payer: PACE Senior Care Partners |
$64.72
|
| Rate for Payer: PACE SWMI |
$68.12
|
| Rate for Payer: PHP Commercial |
$231.62
|
| Rate for Payer: PHP Medicare Advantage |
$68.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.07
|
| Rate for Payer: Priority Health Medicare |
$68.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.19
|
| Rate for Payer: Railroad Medicare Medicare |
$68.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.79
|
| Rate for Payer: UHC Core |
$227.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.12
|
| Rate for Payer: UHC Medicare Advantage |
$70.17
|
| Rate for Payer: VA VA |
$68.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.37
|
|
|
HC BENIGN HYPERKERATOTIC LESION
|
Facility
|
IP
|
$272.49
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
76100041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$245.24 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: BCBS Trust/PPO |
$210.58
|
| Rate for Payer: BCN Commercial |
$210.58
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.99
|
| Rate for Payer: Healthscope Commercial |
$245.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.62
|
| Rate for Payer: PHP Commercial |
$231.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.79
|
| Rate for Payer: UHC Core |
$227.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.37
|
|
|
HC BENZO CONFIRMATION CMPT 1
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
CPT 80347
|
| Hospital Charge Code |
30000164
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna Commercial |
$29.75
|
| Rate for Payer: Aetna Medicare |
$9.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.94
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$8.75
|
| Rate for Payer: BCBS Trust/PPO |
$27.21
|
| Rate for Payer: BCN Commercial |
$27.21
|
| Rate for Payer: BCN Medicare Advantage |
$8.75
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.75
|
| Rate for Payer: Healthscope Commercial |
$31.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.75
|
| Rate for Payer: PACE Senior Care Partners |
$8.31
|
| Rate for Payer: PACE SWMI |
$8.75
|
| Rate for Payer: PHP Commercial |
$29.75
|
| Rate for Payer: PHP Medicare Advantage |
$8.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.45
|
| Rate for Payer: Priority Health Medicare |
$8.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.35
|
| Rate for Payer: Railroad Medicare Medicare |
$8.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.80
|
| Rate for Payer: UHC Core |
$29.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.75
|
| Rate for Payer: UHC Medicare Advantage |
$9.01
|
| Rate for Payer: VA VA |
$8.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.25
|
|
|
HC BENZO CONFIRMATION CMPT 1
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
CPT 80347
|
| Hospital Charge Code |
30000164
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.35 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna Commercial |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$27.05
|
| Rate for Payer: BCN Commercial |
$27.05
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.00
|
| Rate for Payer: Healthscope Commercial |
$31.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.75
|
| Rate for Payer: PHP Commercial |
$29.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.80
|
| Rate for Payer: UHC Core |
$29.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.25
|
|
|
HC BENZO CONFIRMATION CMPT 2
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 80368
|
| Hospital Charge Code |
30000165
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Aetna Commercial |
$27.20
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$24.88
|
| Rate for Payer: BCN Commercial |
$24.88
|
| Rate for Payer: BCN Medicare Advantage |
$8.00
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$27.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$28.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.20
|
| Rate for Payer: PACE Senior Care Partners |
$7.60
|
| Rate for Payer: PACE SWMI |
$8.00
|
| Rate for Payer: PHP Commercial |
$27.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.84
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.52
|
| Rate for Payer: Railroad Medicare Medicare |
$8.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.16
|
| Rate for Payer: UHC Core |
$26.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.00
|
| Rate for Payer: UHC Medicare Advantage |
$8.24
|
| Rate for Payer: VA VA |
$8.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.00
|
|
|
HC BENZO CONFIRMATION CMPT 2
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 80368
|
| Hospital Charge Code |
30000165
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Aetna Commercial |
$27.20
|
| Rate for Payer: BCBS Trust/PPO |
$24.73
|
| Rate for Payer: BCN Commercial |
$24.73
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$27.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.60
|
| Rate for Payer: Healthscope Commercial |
$28.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.20
|
| Rate for Payer: PHP Commercial |
$27.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.16
|
| Rate for Payer: UHC Core |
$26.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.00
|
|
|
HC BENZO CONFIRMATION, U
|
Facility
|
IP
|
$30.04
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
30000163
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$27.04 |
| Rate for Payer: Aetna Commercial |
$25.53
|
| Rate for Payer: BCBS Trust/PPO |
$23.21
|
| Rate for Payer: BCN Commercial |
$23.21
|
| Rate for Payer: Cash Price |
$24.03
|
| Rate for Payer: Cofinity Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.03
|
| Rate for Payer: Healthscope Commercial |
$27.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.53
|
| Rate for Payer: PHP Commercial |
$25.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.44
|
| Rate for Payer: UHC Core |
$25.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.53
|
|
|
HC BENZO CONFIRMATION, U
|
Facility
|
OP
|
$30.04
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
30000163
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$27.04 |
| Rate for Payer: Aetna Commercial |
$25.53
|
| Rate for Payer: Aetna Medicare |
$7.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.39
|
| Rate for Payer: BCBS Complete |
$12.02
|
| Rate for Payer: BCBS MAPPO |
$7.51
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCN Commercial |
$23.36
|
| Rate for Payer: BCN Medicare Advantage |
$7.51
|
| Rate for Payer: Cash Price |
$24.03
|
| Rate for Payer: Cofinity Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.51
|
| Rate for Payer: Healthscope Commercial |
$27.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.53
|
| Rate for Payer: PACE Senior Care Partners |
$7.13
|
| Rate for Payer: PACE SWMI |
$7.51
|
| Rate for Payer: PHP Commercial |
$25.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.13
|
| Rate for Payer: Priority Health Medicare |
$7.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.32
|
| Rate for Payer: Railroad Medicare Medicare |
$7.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.44
|
| Rate for Payer: UHC Core |
$25.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.51
|
| Rate for Payer: UHC Medicare Advantage |
$7.74
|
| Rate for Payer: VA VA |
$7.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.53
|
|
|
HC BENZODIAZAPINE URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC BENZODIAZAPINE URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC BENZODIAZEPINE URINE CONFIRM
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30100594
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.81 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: BCBS Trust/PPO |
$47.91
|
| Rate for Payer: BCN Commercial |
$47.91
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC BENZODIAZEPINE URINE CONFIRM
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30100594
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.72 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PACE Senior Care Partners |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC BERMUDA GRASS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200119
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC BERMUDA GRASS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200119
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC BETA 2 GLYCOPROTEIN I CMPT
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200139
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I CMPT
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200139
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGA M A
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200444
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGA M A
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200444
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200459
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200459
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG M A
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200140
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG M A
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200140
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GLYCOPROTEIN I IGM M A
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200443
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
