|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$19.32
|
| Rate for Payer: BCN Commercial |
$19.32
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
IP
|
$36.80
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$33.12 |
| Rate for Payer: Aetna Commercial |
$31.28
|
| Rate for Payer: BCBS Trust/PPO |
$28.44
|
| Rate for Payer: BCN Commercial |
$28.44
|
| Rate for Payer: Cash Price |
$29.44
|
| Rate for Payer: Cofinity Commercial |
$31.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.44
|
| Rate for Payer: Healthscope Commercial |
$33.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.28
|
| Rate for Payer: PHP Commercial |
$31.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.38
|
| Rate for Payer: UHC Core |
$30.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.60
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
OP
|
$36.80
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$48.52 |
| Rate for Payer: Aetna Commercial |
$31.28
|
| Rate for Payer: Aetna Medicare |
$9.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.50
|
| Rate for Payer: BCBS Complete |
$48.52
|
| Rate for Payer: BCBS MAPPO |
$9.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.61
|
| Rate for Payer: BCN Commercial |
$28.61
|
| Rate for Payer: BCN Medicare Advantage |
$9.20
|
| Rate for Payer: Cash Price |
$29.44
|
| Rate for Payer: Cash Price |
$29.44
|
| Rate for Payer: Cofinity Commercial |
$31.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.20
|
| Rate for Payer: Healthscope Commercial |
$33.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.60
|
| Rate for Payer: Mclaren Medicaid |
$46.21
|
| Rate for Payer: Meridian Medicaid |
$48.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.28
|
| Rate for Payer: PACE Senior Care Partners |
$8.74
|
| Rate for Payer: PACE SWMI |
$9.20
|
| Rate for Payer: PHP Commercial |
$31.28
|
| Rate for Payer: PHP Medicare Advantage |
$9.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.02
|
| Rate for Payer: Priority Health Medicare |
$9.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.38
|
| Rate for Payer: UHC Core |
$30.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.20
|
| Rate for Payer: UHC Medicare Advantage |
$9.48
|
| Rate for Payer: VA VA |
$9.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.60
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
IP
|
$27.00
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$24.30 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$20.87
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$23.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.60
|
| Rate for Payer: Healthscope Commercial |
$24.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.95
|
| Rate for Payer: PHP Commercial |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.76
|
| Rate for Payer: UHC Core |
$22.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.25
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$24.30 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$7.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.44
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$6.75
|
| Rate for Payer: BCBS Trust/PPO |
$20.99
|
| Rate for Payer: BCN Commercial |
$20.99
|
| Rate for Payer: BCN Medicare Advantage |
$6.75
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$23.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.75
|
| Rate for Payer: Healthscope Commercial |
$24.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.95
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE SWMI |
$6.75
|
| Rate for Payer: PHP Commercial |
$22.95
|
| Rate for Payer: PHP Medicare Advantage |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.49
|
| Rate for Payer: Priority Health Medicare |
$6.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.47
|
| Rate for Payer: Railroad Medicare Medicare |
$6.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.76
|
| Rate for Payer: UHC Core |
$22.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.75
|
| Rate for Payer: UHC Medicare Advantage |
$6.95
|
| Rate for Payer: VA VA |
$6.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.25
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.81 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna Medicare |
$6.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.65
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$6.12
|
| Rate for Payer: BCBS Trust/PPO |
$19.03
|
| Rate for Payer: BCN Commercial |
$19.03
|
| Rate for Payer: BCN Medicare Advantage |
$6.12
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: PACE Senior Care Partners |
$5.81
|
| Rate for Payer: PACE SWMI |
$6.12
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: PHP Medicare Advantage |
$6.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.30
|
| Rate for Payer: Priority Health Medicare |
$6.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.54
|
| Rate for Payer: UHC Core |
$20.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.12
|
| Rate for Payer: UHC Medicare Advantage |
$6.30
|
| Rate for Payer: VA VA |
$6.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.93 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$18.92
|
| Rate for Payer: BCN Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.54
|
| Rate for Payer: UHC Core |
$20.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
IP
|
$38.25
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.33 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Aetna Commercial |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$29.56
|
| Rate for Payer: BCN Commercial |
$29.56
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$34.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.51
|
| Rate for Payer: PHP Commercial |
$32.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC Core |
$31.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.69
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
OP
|
$38.25
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Aetna Commercial |
$32.51
|
| Rate for Payer: Aetna Medicare |
$9.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.95
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$9.56
|
| Rate for Payer: BCBS Trust/PPO |
$29.74
|
| Rate for Payer: BCN Commercial |
$29.74
|
| Rate for Payer: BCN Medicare Advantage |
$9.56
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.56
|
| Rate for Payer: Healthscope Commercial |
$34.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.69
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.51
|
| Rate for Payer: PACE Senior Care Partners |
$9.08
|
| Rate for Payer: PACE SWMI |
$9.56
|
| Rate for Payer: PHP Commercial |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$9.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.28
|
| Rate for Payer: Priority Health Medicare |
$9.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.33
|
| Rate for Payer: Railroad Medicare Medicare |
$9.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC Core |
$31.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.56
|
| Rate for Payer: UHC Medicare Advantage |
$9.85
|
| Rate for Payer: VA VA |
$9.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.69
|
|
|
HC IMMUNOASSAY MULTI STEP FIRST
|
Facility
|
OP
|
$38.25
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100657
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Aetna Commercial |
$32.51
|
| Rate for Payer: Aetna Medicare |
$9.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.95
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$9.56
|
| Rate for Payer: BCBS Trust/PPO |
$29.74
|
| Rate for Payer: BCN Commercial |
$29.74
|
| Rate for Payer: BCN Medicare Advantage |
$9.56
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.56
|
| Rate for Payer: Healthscope Commercial |
$34.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.69
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.51
|
| Rate for Payer: PACE Senior Care Partners |
$9.08
|
| Rate for Payer: PACE SWMI |
$9.56
|
| Rate for Payer: PHP Commercial |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$9.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.28
|
| Rate for Payer: Priority Health Medicare |
$9.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.33
|
| Rate for Payer: Railroad Medicare Medicare |
$9.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC Core |
$31.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.56
|
| Rate for Payer: UHC Medicare Advantage |
$9.85
|
| Rate for Payer: VA VA |
$9.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.69
|
|
|
HC IMMUNOASSAY MULTI STEP FIRST
|
Facility
|
IP
|
$38.25
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100657
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.33 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Aetna Commercial |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$29.56
|
| Rate for Payer: BCN Commercial |
$29.56
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cofinity Commercial |
$32.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$34.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.51
|
| Rate for Payer: PHP Commercial |
$32.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC Core |
$31.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.69
|
|
|
HC IMMUNODIFFUSION
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
30200191
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$110.70 |
| Rate for Payer: Aetna Commercial |
$104.55
|
| Rate for Payer: Aetna Medicare |
$31.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.44
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$30.75
|
| Rate for Payer: BCBS Trust/PPO |
$95.63
|
| Rate for Payer: BCN Commercial |
$95.63
|
| Rate for Payer: BCN Medicare Advantage |
$30.75
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$105.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.75
|
| Rate for Payer: Healthscope Commercial |
$110.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.25
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.55
|
| Rate for Payer: PACE Senior Care Partners |
$29.21
|
| Rate for Payer: PACE SWMI |
$30.75
|
| Rate for Payer: PHP Commercial |
$104.55
|
| Rate for Payer: PHP Medicare Advantage |
$30.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.01
|
| Rate for Payer: Priority Health Medicare |
$30.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.02
|
| Rate for Payer: Railroad Medicare Medicare |
$30.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.24
|
| Rate for Payer: UHC Core |
$102.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.75
|
| Rate for Payer: UHC Medicare Advantage |
$31.67
|
| Rate for Payer: VA VA |
$30.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.25
|
|
|
HC IMMUNODIFFUSION
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
30200191
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$75.02 |
| Max. Negotiated Rate |
$110.70 |
| Rate for Payer: Aetna Commercial |
$104.55
|
| Rate for Payer: BCBS Trust/PPO |
$95.05
|
| Rate for Payer: BCN Commercial |
$95.05
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$105.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.40
|
| Rate for Payer: Healthscope Commercial |
$110.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.55
|
| Rate for Payer: PHP Commercial |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.24
|
| Rate for Payer: UHC Core |
$102.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.25
|
|
|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
IP
|
$77.52
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.28 |
| Max. Negotiated Rate |
$69.77 |
| Rate for Payer: Aetna Commercial |
$65.89
|
| Rate for Payer: BCBS Trust/PPO |
$59.91
|
| Rate for Payer: BCN Commercial |
$59.91
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cofinity Commercial |
$66.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.02
|
| Rate for Payer: Healthscope Commercial |
$69.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.89
|
| Rate for Payer: PHP Commercial |
$65.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.22
|
| Rate for Payer: UHC Core |
$64.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.14
|
|
|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
OP
|
$77.52
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$69.77 |
| Rate for Payer: Aetna Commercial |
$65.89
|
| Rate for Payer: Aetna Medicare |
$20.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.22
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$19.38
|
| Rate for Payer: BCBS Trust/PPO |
$60.27
|
| Rate for Payer: BCN Commercial |
$60.27
|
| Rate for Payer: BCN Medicare Advantage |
$19.38
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cofinity Commercial |
$66.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.38
|
| Rate for Payer: Healthscope Commercial |
$69.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.14
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.89
|
| Rate for Payer: PACE Senior Care Partners |
$18.41
|
| Rate for Payer: PACE SWMI |
$19.38
|
| Rate for Payer: PHP Commercial |
$65.89
|
| Rate for Payer: PHP Medicare Advantage |
$19.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.44
|
| Rate for Payer: Priority Health Medicare |
$19.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.22
|
| Rate for Payer: UHC Core |
$64.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.38
|
| Rate for Payer: UHC Medicare Advantage |
$19.96
|
| Rate for Payer: VA VA |
$19.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.14
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$23.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.05
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$69.79
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: BCN Medicare Advantage |
$22.44
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.44
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.30
|
| Rate for Payer: PACE Senior Care Partners |
$21.32
|
| Rate for Payer: PACE SWMI |
$22.44
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.09
|
| Rate for Payer: Priority Health Medicare |
$22.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$23.11
|
| Rate for Payer: VA VA |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: BCBS Trust/PPO |
$69.37
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.30
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC IMMUNOFIXATION
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.49 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$23.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.05
|
| Rate for Payer: BCBS Complete |
$17.31
|
| Rate for Payer: BCBS MAPPO |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$69.79
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: BCN Medicare Advantage |
$22.44
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.44
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Mclaren Medicaid |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$17.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.30
|
| Rate for Payer: PACE Senior Care Partners |
$21.32
|
| Rate for Payer: PACE SWMI |
$22.44
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.09
|
| Rate for Payer: Priority Health Medicare |
$22.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$23.11
|
| Rate for Payer: VA VA |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC IMMUNOFIXATION
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: BCBS Trust/PPO |
$69.37
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.30
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
IP
|
$165.80
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$101.12 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$140.93
|
| Rate for Payer: BCBS Trust/PPO |
$128.13
|
| Rate for Payer: BCN Commercial |
$128.13
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.64
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.93
|
| Rate for Payer: PHP Commercial |
$140.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.90
|
| Rate for Payer: UHC Core |
$138.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.35
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
OP
|
$165.80
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.49 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$140.93
|
| Rate for Payer: Aetna Medicare |
$43.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.81
|
| Rate for Payer: BCBS Complete |
$17.31
|
| Rate for Payer: BCBS MAPPO |
$41.45
|
| Rate for Payer: BCBS Trust/PPO |
$128.91
|
| Rate for Payer: BCN Commercial |
$128.91
|
| Rate for Payer: BCN Medicare Advantage |
$41.45
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.45
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.35
|
| Rate for Payer: Mclaren Medicaid |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$17.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.93
|
| Rate for Payer: PACE Senior Care Partners |
$39.38
|
| Rate for Payer: PACE SWMI |
$41.45
|
| Rate for Payer: PHP Commercial |
$140.93
|
| Rate for Payer: PHP Medicare Advantage |
$41.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.25
|
| Rate for Payer: Priority Health Medicare |
$41.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.12
|
| Rate for Payer: Railroad Medicare Medicare |
$41.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.90
|
| Rate for Payer: UHC Core |
$138.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.45
|
| Rate for Payer: UHC Medicare Advantage |
$42.69
|
| Rate for Payer: VA VA |
$41.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.35
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
IP
|
$165.80
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$101.12 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$140.93
|
| Rate for Payer: BCBS Trust/PPO |
$128.13
|
| Rate for Payer: BCN Commercial |
$128.13
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.64
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.93
|
| Rate for Payer: PHP Commercial |
$140.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.90
|
| Rate for Payer: UHC Core |
$138.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.35
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
OP
|
$165.80
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.66 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$140.93
|
| Rate for Payer: Aetna Medicare |
$43.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.81
|
| Rate for Payer: BCBS Complete |
$22.74
|
| Rate for Payer: BCBS MAPPO |
$41.45
|
| Rate for Payer: BCBS Trust/PPO |
$128.91
|
| Rate for Payer: BCN Commercial |
$128.91
|
| Rate for Payer: BCN Medicare Advantage |
$41.45
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.45
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.35
|
| Rate for Payer: Mclaren Medicaid |
$21.66
|
| Rate for Payer: Meridian Medicaid |
$22.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.93
|
| Rate for Payer: PACE Senior Care Partners |
$39.38
|
| Rate for Payer: PACE SWMI |
$41.45
|
| Rate for Payer: PHP Commercial |
$140.93
|
| Rate for Payer: PHP Medicare Advantage |
$41.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.25
|
| Rate for Payer: Priority Health Medicare |
$41.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.12
|
| Rate for Payer: Railroad Medicare Medicare |
$41.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.90
|
| Rate for Payer: UHC Core |
$138.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.45
|
| Rate for Payer: UHC Medicare Advantage |
$42.69
|
| Rate for Payer: VA VA |
$41.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.35
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$58.27
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$7.21
|
| Rate for Payer: BCBS MAPPO |
$18.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.85
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.85
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$6.86
|
| Rate for Payer: Meridian Medicaid |
$7.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.91
|
| Rate for Payer: PACE SWMI |
$18.85
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Medicare |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: Railroad Medicare Medicare |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$19.42
|
| Rate for Payer: VA VA |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
