|
HC CX ID BY PCR AMPLIFIED, PSAR
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600239
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, S.AUREUS
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600229
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.42
|
| Rate for Payer: BCN Commercial |
$48.42
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, S.AUREUS
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600229
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, SERRATIA
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600246
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, SERRATIA
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600246
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.42
|
| Rate for Payer: BCN Commercial |
$48.42
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, SPNE
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600233
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, SPNE
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600233
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.42
|
| Rate for Payer: BCN Commercial |
$48.42
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, STAPH
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600228
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.42
|
| Rate for Payer: BCN Commercial |
$48.42
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, STAPH
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600228
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.42
|
| Rate for Payer: BCN Commercial |
$48.42
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Mclaren Medicaid |
$10.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicaid |
$10.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$10.34
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.42
|
| Rate for Payer: BCN Commercial |
$48.42
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
OP
|
$32.47
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Aetna Commercial |
$27.60
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.15
|
| Rate for Payer: BCBS Complete |
$6.01
|
| Rate for Payer: BCBS MAPPO |
$8.12
|
| Rate for Payer: BCBS Trust/PPO |
$26.69
|
| Rate for Payer: BCN Commercial |
$26.69
|
| Rate for Payer: BCN Medicare Advantage |
$8.12
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$27.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.12
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.35
|
| Rate for Payer: Mclaren Medicaid |
$5.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.52
|
| Rate for Payer: Meridian Medicaid |
$6.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.35
|
| Rate for Payer: PACE Senior Care Partners |
$7.71
|
| Rate for Payer: PACE SWMI |
$8.12
|
| Rate for Payer: PHP Commercial |
$27.60
|
| Rate for Payer: PHP Medicare Advantage |
$8.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.25
|
| Rate for Payer: Priority Health Medicare |
$8.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.60
|
| Rate for Payer: Railroad Medicare Medicare |
$8.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.57
|
| Rate for Payer: UHC Core |
$27.11
|
| Rate for Payer: UHC Exchange |
$8.12
|
| Rate for Payer: UHC Medicaid |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$8.12
|
| Rate for Payer: UHCCP Medicaid |
$5.72
|
| Rate for Payer: VA VA |
$8.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.35
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
IP
|
$32.47
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Aetna Commercial |
$27.60
|
| Rate for Payer: BCBS Trust/PPO |
$26.82
|
| Rate for Payer: BCN Commercial |
$26.82
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$27.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.35
|
| Rate for Payer: PHP Commercial |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.57
|
| Rate for Payer: UHC Core |
$27.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.35
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$4.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.97
|
| Rate for Payer: BCBS Complete |
$3.54
|
| Rate for Payer: BCBS MAPPO |
$4.78
|
| Rate for Payer: BCBS Trust/PPO |
$15.70
|
| Rate for Payer: BCN Commercial |
$15.70
|
| Rate for Payer: BCN Medicare Advantage |
$4.78
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.78
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Mclaren Medicaid |
$3.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.01
|
| Rate for Payer: Meridian Medicaid |
$3.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PACE Senior Care Partners |
$4.54
|
| Rate for Payer: PACE SWMI |
$4.78
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Medicare Advantage |
$4.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.62
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.29
|
| Rate for Payer: Railroad Medicare Medicare |
$4.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.81
|
| Rate for Payer: UHC Core |
$15.95
|
| Rate for Payer: UHC Exchange |
$4.78
|
| Rate for Payer: UHC Medicaid |
$3.37
|
| Rate for Payer: UHC Medicare Advantage |
$4.78
|
| Rate for Payer: UHCCP Medicaid |
$3.37
|
| Rate for Payer: VA VA |
$4.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.81
|
| Rate for Payer: UHC Core |
$15.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.03 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$40.39
|
| Rate for Payer: BCN Commercial |
$40.39
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$9.05
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.03
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicaid |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$8.62
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC CYCLOSPORINE
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYCLOSPORINE
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYGNUS MATRIX 2X3 PER SQ CM
|
Facility
|
IP
|
$337.88
|
|
|
Service Code
|
HCPCS Q4199
|
| Hospital Charge Code |
63600266
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$235.16 |
| Max. Negotiated Rate |
$304.09 |
| Rate for Payer: Aetna Commercial |
$287.20
|
| Rate for Payer: BCBS Trust/PPO |
$279.06
|
| Rate for Payer: BCN Commercial |
$279.06
|
| Rate for Payer: Cash Price |
$270.30
|
| Rate for Payer: Cofinity Commercial |
$290.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.30
|
| Rate for Payer: Healthscope Commercial |
$304.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.20
|
| Rate for Payer: Nomi Health Commercial |
$277.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.41
|
| Rate for Payer: PHP Commercial |
$287.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$293.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.33
|
| Rate for Payer: UHC Core |
$282.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.41
|
|
|
HC CYGNUS MATRIX 2X3 PER SQ CM
|
Facility
|
OP
|
$337.88
|
|
|
Service Code
|
HCPCS Q4199
|
| Hospital Charge Code |
63600266
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.57 |
| Max. Negotiated Rate |
$304.09 |
| Rate for Payer: Aetna Commercial |
$287.20
|
| Rate for Payer: Aetna Medicare |
$87.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.59
|
| Rate for Payer: BCBS Complete |
$62.54
|
| Rate for Payer: BCBS MAPPO |
$84.47
|
| Rate for Payer: BCBS Trust/PPO |
$277.77
|
| Rate for Payer: BCN Commercial |
$277.77
|
| Rate for Payer: BCN Medicare Advantage |
$84.47
|
| Rate for Payer: Cash Price |
$270.30
|
| Rate for Payer: Cofinity Commercial |
$290.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.47
|
| Rate for Payer: Healthscope Commercial |
$304.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.41
|
| Rate for Payer: Mclaren Medicaid |
$59.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.69
|
| Rate for Payer: Meridian Medicaid |
$62.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.20
|
| Rate for Payer: Nomi Health Commercial |
$277.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.41
|
| Rate for Payer: PACE Senior Care Partners |
$80.25
|
| Rate for Payer: PACE SWMI |
$84.47
|
| Rate for Payer: PHP Commercial |
$287.20
|
| Rate for Payer: PHP Medicare Advantage |
$84.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$293.96
|
| Rate for Payer: Priority Health Medicare |
$85.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.16
|
| Rate for Payer: Railroad Medicare Medicare |
$84.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.33
|
| Rate for Payer: UHC Core |
$282.13
|
| Rate for Payer: UHC Exchange |
$84.47
|
| Rate for Payer: UHC Medicaid |
$59.57
|
| Rate for Payer: UHC Medicare Advantage |
$84.47
|
| Rate for Payer: UHCCP Medicaid |
$59.57
|
| Rate for Payer: VA VA |
$84.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.41
|
|
|
HC CYGNUS MATRIX 4X4 PER SQ CM
|
Facility
|
IP
|
$227.11
|
|
|
Service Code
|
HCPCS Q4199
|
| Hospital Charge Code |
63600267
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$158.07 |
| Max. Negotiated Rate |
$204.40 |
| Rate for Payer: Aetna Commercial |
$193.04
|
| Rate for Payer: BCBS Trust/PPO |
$187.57
|
| Rate for Payer: BCN Commercial |
$187.57
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$195.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.69
|
| Rate for Payer: Healthscope Commercial |
$204.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.04
|
| Rate for Payer: Nomi Health Commercial |
$186.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.33
|
| Rate for Payer: PHP Commercial |
$193.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$197.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.86
|
| Rate for Payer: UHC Core |
$189.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.33
|
|
|
HC CYGNUS MATRIX 4X4 PER SQ CM
|
Facility
|
OP
|
$227.11
|
|
|
Service Code
|
HCPCS Q4199
|
| Hospital Charge Code |
63600267
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$204.40 |
| Rate for Payer: Aetna Commercial |
$193.04
|
| Rate for Payer: Aetna Medicare |
$59.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.97
|
| Rate for Payer: BCBS Complete |
$42.04
|
| Rate for Payer: BCBS MAPPO |
$56.78
|
| Rate for Payer: BCBS Trust/PPO |
$186.71
|
| Rate for Payer: BCN Commercial |
$186.71
|
| Rate for Payer: BCN Medicare Advantage |
$56.78
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$195.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.78
|
| Rate for Payer: Healthscope Commercial |
$204.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.33
|
| Rate for Payer: Mclaren Medicaid |
$40.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.62
|
| Rate for Payer: Meridian Medicaid |
$42.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.04
|
| Rate for Payer: Nomi Health Commercial |
$186.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.33
|
| Rate for Payer: PACE Senior Care Partners |
$53.94
|
| Rate for Payer: PACE SWMI |
$56.78
|
| Rate for Payer: PHP Commercial |
$193.04
|
| Rate for Payer: PHP Medicare Advantage |
$56.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$197.59
|
| Rate for Payer: Priority Health Medicare |
$57.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.07
|
| Rate for Payer: Railroad Medicare Medicare |
$56.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.86
|
| Rate for Payer: UHC Core |
$189.64
|
| Rate for Payer: UHC Exchange |
$56.78
|
| Rate for Payer: UHC Medicaid |
$40.04
|
| Rate for Payer: UHC Medicare Advantage |
$56.78
|
| Rate for Payer: UHCCP Medicaid |
$40.04
|
| Rate for Payer: VA VA |
$56.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.33
|
|
