|
HC EZPAP SUPPLY
|
Facility
|
OP
|
$125.48
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.80 |
| Max. Negotiated Rate |
$112.93 |
| Rate for Payer: Aetna Commercial |
$106.66
|
| Rate for Payer: Aetna Medicare |
$32.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.21
|
| Rate for Payer: BCBS Complete |
$50.19
|
| Rate for Payer: BCBS MAPPO |
$31.37
|
| Rate for Payer: BCBS Trust/PPO |
$97.56
|
| Rate for Payer: BCN Commercial |
$97.56
|
| Rate for Payer: BCN Medicare Advantage |
$31.37
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cofinity Commercial |
$107.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.37
|
| Rate for Payer: Healthscope Commercial |
$112.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.66
|
| Rate for Payer: PACE Senior Care Partners |
$29.80
|
| Rate for Payer: PACE SWMI |
$31.37
|
| Rate for Payer: PHP Commercial |
$106.66
|
| Rate for Payer: PHP Medicare Advantage |
$31.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.17
|
| Rate for Payer: Priority Health Medicare |
$31.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.53
|
| Rate for Payer: Railroad Medicare Medicare |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.42
|
| Rate for Payer: UHC Core |
$104.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.37
|
| Rate for Payer: UHC Medicare Advantage |
$32.31
|
| Rate for Payer: VA VA |
$31.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.11
|
|
|
HC EZPAP SUPPLY
|
Facility
|
IP
|
$125.48
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.53 |
| Max. Negotiated Rate |
$112.93 |
| Rate for Payer: Aetna Commercial |
$106.66
|
| Rate for Payer: BCBS Trust/PPO |
$96.97
|
| Rate for Payer: BCN Commercial |
$96.97
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cofinity Commercial |
$107.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.38
|
| Rate for Payer: Healthscope Commercial |
$112.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.66
|
| Rate for Payer: PHP Commercial |
$106.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.42
|
| Rate for Payer: UHC Core |
$104.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.11
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
OP
|
$475.24
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$112.87 |
| Max. Negotiated Rate |
$427.72 |
| Rate for Payer: Aetna Commercial |
$403.95
|
| Rate for Payer: Aetna Medicare |
$123.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.51
|
| Rate for Payer: BCBS Complete |
$190.10
|
| Rate for Payer: BCBS MAPPO |
$118.81
|
| Rate for Payer: BCBS Trust/PPO |
$369.50
|
| Rate for Payer: BCN Commercial |
$369.50
|
| Rate for Payer: BCN Medicare Advantage |
$118.81
|
| Rate for Payer: Cash Price |
$380.19
|
| Rate for Payer: Cofinity Commercial |
$408.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.81
|
| Rate for Payer: Healthscope Commercial |
$427.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$403.95
|
| Rate for Payer: PACE Senior Care Partners |
$112.87
|
| Rate for Payer: PACE SWMI |
$118.81
|
| Rate for Payer: PHP Commercial |
$403.95
|
| Rate for Payer: PHP Medicare Advantage |
$118.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.46
|
| Rate for Payer: Priority Health Medicare |
$118.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.85
|
| Rate for Payer: Railroad Medicare Medicare |
$118.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.21
|
| Rate for Payer: UHC Core |
$396.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.81
|
| Rate for Payer: UHC Medicare Advantage |
$122.37
|
| Rate for Payer: VA VA |
$118.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.43
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
IP
|
$475.24
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$289.85 |
| Max. Negotiated Rate |
$427.72 |
| Rate for Payer: Aetna Commercial |
$403.95
|
| Rate for Payer: BCBS Trust/PPO |
$367.27
|
| Rate for Payer: BCN Commercial |
$367.27
|
| Rate for Payer: Cash Price |
$380.19
|
| Rate for Payer: Cofinity Commercial |
$408.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.19
|
| Rate for Payer: Healthscope Commercial |
$427.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$403.95
|
| Rate for Payer: PHP Commercial |
$403.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.21
|
| Rate for Payer: UHC Core |
$396.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.43
|
|
|
HC F232 OVALBUMIN
|
Facility
|
OP
|
$28.18
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.69 |
| Max. Negotiated Rate |
$25.36 |
| Rate for Payer: Aetna Commercial |
$23.95
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.81
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.04
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: BCN Medicare Advantage |
$7.04
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cofinity Commercial |
$24.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.04
|
| Rate for Payer: Healthscope Commercial |
$25.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.95
|
| Rate for Payer: PACE Senior Care Partners |
$6.69
|
| Rate for Payer: PACE SWMI |
$7.04
|
| Rate for Payer: PHP Commercial |
$23.95
|
| Rate for Payer: PHP Medicare Advantage |
$7.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.52
|
| Rate for Payer: Priority Health Medicare |
$7.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.19
|
| Rate for Payer: Railroad Medicare Medicare |
$7.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.80
|
| Rate for Payer: UHC Core |
$23.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.04
|
| Rate for Payer: UHC Medicare Advantage |
$7.26
|
| Rate for Payer: VA VA |
$7.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
|
|
HC F232 OVALBUMIN
|
Facility
|
IP
|
$28.18
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$25.36 |
| Rate for Payer: Aetna Commercial |
$23.95
|
| Rate for Payer: BCBS Trust/PPO |
$21.78
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cofinity Commercial |
$24.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.54
|
| Rate for Payer: Healthscope Commercial |
$25.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.95
|
| Rate for Payer: PHP Commercial |
$23.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.80
|
| Rate for Payer: UHC Core |
$23.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
|
|
HC F233 OVOMUCOID
|
Facility
|
OP
|
$28.18
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.69 |
| Max. Negotiated Rate |
$25.36 |
| Rate for Payer: Aetna Commercial |
$23.95
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.81
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.04
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: BCN Medicare Advantage |
$7.04
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cofinity Commercial |
$24.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.04
|
| Rate for Payer: Healthscope Commercial |
$25.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.95
|
| Rate for Payer: PACE Senior Care Partners |
$6.69
|
| Rate for Payer: PACE SWMI |
$7.04
|
| Rate for Payer: PHP Commercial |
$23.95
|
| Rate for Payer: PHP Medicare Advantage |
$7.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.52
|
| Rate for Payer: Priority Health Medicare |
$7.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.19
|
| Rate for Payer: Railroad Medicare Medicare |
$7.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.80
|
| Rate for Payer: UHC Core |
$23.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.04
|
| Rate for Payer: UHC Medicare Advantage |
$7.26
|
| Rate for Payer: VA VA |
$7.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
|
|
HC F233 OVOMUCOID
|
Facility
|
IP
|
$28.18
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$25.36 |
| Rate for Payer: Aetna Commercial |
$23.95
|
| Rate for Payer: BCBS Trust/PPO |
$21.78
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cofinity Commercial |
$24.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.54
|
| Rate for Payer: Healthscope Commercial |
$25.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.95
|
| Rate for Payer: PHP Commercial |
$23.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.80
|
| Rate for Payer: UHC Core |
$23.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F423 RARA H2 PEANUT
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200447
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F423 RARA H2 PEANUT
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200447
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F424 RARA H3 PEANUT
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200448
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F424 RARA H3 PEANUT
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200448
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F427 RARA H9 LTP PEANUT
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200451
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F427 RARA H9 LTP PEANUT
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200451
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F447 RARA H6 PEANUT
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200449
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F447 RARA H6 PEANUT
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200449
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F76 ALPHA-LACTALBUMIN
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200442
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F76 ALPHA-LACTALBUMIN
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200442
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F77 BETA-LACTOGLOBULIN
|
Facility
|
IP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200445
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$23.86
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F77 BETA-LACTOGLOBULIN
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200445
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
|
HC F78 CASEIN
|
Facility
|
OP
|
$30.87
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200441
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$27.78 |
| Rate for Payer: Aetna Commercial |
$26.24
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.65
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$24.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cash Price |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$26.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.15
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.33
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.24
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.86
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.17
|
| Rate for Payer: UHC Core |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.15
|
|
