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Charge Type Price  
Service Code HCPCS J0153
Hospital Charge Code 8975
Hospital Revenue Code 636
Min. Negotiated Rate $15.09
Max. Negotiated Rate $22.27
Rate for Payer: Aetna Commercial $21.03
Rate for Payer: Aetna Commercial $15.34
Rate for Payer: Aetna Commercial $21.50
Rate for Payer: Aetna Commercial $21.47
Rate for Payer: BCBS Trust/PPO $19.52
Rate for Payer: BCBS Trust/PPO $13.95
Rate for Payer: BCBS Trust/PPO $19.12
Rate for Payer: BCBS Trust/PPO $19.54
Rate for Payer: BCN Commercial $19.52
Rate for Payer: BCN Commercial $19.54
Rate for Payer: BCN Commercial $19.12
Rate for Payer: BCN Commercial $13.95
Rate for Payer: Cash Price $14.44
Rate for Payer: Cash Price $20.23
Rate for Payer: Cash Price $20.21
Rate for Payer: Cash Price $19.79
Rate for Payer: Cofinity Commercial $21.28
Rate for Payer: Cofinity Commercial $15.52
Rate for Payer: Cofinity Commercial $21.72
Rate for Payer: Cofinity Commercial $21.75
Rate for Payer: Encore Health Key Benefits Commercial $20.21
Rate for Payer: Encore Health Key Benefits Commercial $19.79
Rate for Payer: Encore Health Key Benefits Commercial $20.23
Rate for Payer: Encore Health Key Benefits Commercial $14.44
Rate for Payer: Healthscope Commercial $22.73
Rate for Payer: Healthscope Commercial $16.24
Rate for Payer: Healthscope Commercial $22.27
Rate for Payer: Healthscope Commercial $22.76
Rate for Payer: Lakeland Regional Health Systems Commercial $18.97
Rate for Payer: Lakeland Regional Health Systems Commercial $18.56
Rate for Payer: Lakeland Regional Health Systems Commercial $18.94
Rate for Payer: Lakeland Regional Health Systems Commercial $13.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $15.34
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $21.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $21.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $21.47
Rate for Payer: PHP Commercial $15.34
Rate for Payer: PHP Commercial $21.03
Rate for Payer: PHP Commercial $21.47
Rate for Payer: PHP Commercial $21.50
Rate for Payer: Priority Health Cigna Priority Health $17.32
Rate for Payer: Priority Health Cigna Priority Health $17.68
Rate for Payer: Priority Health Cigna Priority Health $12.64
Rate for Payer: Priority Health Cigna Priority Health $17.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network $15.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network $21.52
Rate for Payer: Priority Health HMO/PPO/Tiered Network $22.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network $21.98
Rate for Payer: Priority Health Narrow/Tiered Network $11.01
Rate for Payer: Priority Health Narrow/Tiered Network $15.09
Rate for Payer: Priority Health Narrow/Tiered Network $15.41
Rate for Payer: Priority Health Narrow/Tiered Network $15.42
Rate for Payer: UHC All Payor (Choice/PPO) $22.23
Rate for Payer: UHC All Payor (Choice/PPO) $22.26
Rate for Payer: UHC All Payor (Choice/PPO) $21.77
Rate for Payer: UHC All Payor (Choice/PPO) $15.88
Rate for Payer: UHC Core $15.07
Rate for Payer: UHC Core $20.66
Rate for Payer: UHC Core $21.09
Rate for Payer: UHC Core $21.12
Rate for Payer: Van Buren County Sheriff Dept. Commercial $18.94
Rate for Payer: Van Buren County Sheriff Dept. Commercial $13.54
Rate for Payer: Van Buren County Sheriff Dept. Commercial $18.56
Rate for Payer: Van Buren County Sheriff Dept. Commercial $18.97
Service Code HCPCS J0153
Hospital Charge Code 163702
Hospital Revenue Code 636
Min. Negotiated Rate $11.01
Max. Negotiated Rate $16.24
Rate for Payer: Aetna Commercial $15.34
Rate for Payer: BCBS Trust/PPO $13.95
Rate for Payer: BCN Commercial $13.95
Rate for Payer: Cash Price $14.44
Rate for Payer: Cofinity Commercial $15.52
Rate for Payer: Encore Health Key Benefits Commercial $14.44
Rate for Payer: Healthscope Commercial $16.24
Rate for Payer: Lakeland Regional Health Systems Commercial $13.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $15.34
Rate for Payer: PHP Commercial $15.34
Rate for Payer: Priority Health Cigna Priority Health $12.64
Rate for Payer: Priority Health HMO/PPO/Tiered Network $15.70
Rate for Payer: Priority Health Narrow/Tiered Network $11.01
Rate for Payer: UHC All Payor (Choice/PPO) $15.88
Rate for Payer: UHC Core $15.07
Rate for Payer: Van Buren County Sheriff Dept. Commercial $13.54
Service Code HCPCS J7613
Hospital Charge Code 250
Hospital Revenue Code 250
Min. Negotiated Rate $2.49
Max. Negotiated Rate $3.68
Rate for Payer: Aetna Commercial $3.48
Rate for Payer: Aetna Commercial $3.24
Rate for Payer: Aetna Commercial $3.72
Rate for Payer: BCBS Trust/PPO $3.16
Rate for Payer: BCBS Trust/PPO $2.94
Rate for Payer: BCBS Trust/PPO $3.38
Rate for Payer: BCN Commercial $3.16
Rate for Payer: BCN Commercial $2.94
Rate for Payer: BCN Commercial $3.38
Rate for Payer: Cash Price $3.50
Rate for Payer: Cash Price $3.05
Rate for Payer: Cash Price $3.27
Rate for Payer: Cofinity Commercial $3.52
Rate for Payer: Cofinity Commercial $3.28
Rate for Payer: Cofinity Commercial $3.77
Rate for Payer: Encore Health Key Benefits Commercial $3.05
Rate for Payer: Encore Health Key Benefits Commercial $3.50
Rate for Payer: Encore Health Key Benefits Commercial $3.27
Rate for Payer: Healthscope Commercial $3.43
Rate for Payer: Healthscope Commercial $3.68
Rate for Payer: Healthscope Commercial $3.94
Rate for Payer: Lakeland Regional Health Systems Commercial $3.28
Rate for Payer: Lakeland Regional Health Systems Commercial $2.86
Rate for Payer: Lakeland Regional Health Systems Commercial $3.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $3.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $3.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $3.24
Rate for Payer: PHP Commercial $3.24
Rate for Payer: PHP Commercial $3.72
Rate for Payer: PHP Commercial $3.48
Rate for Payer: Priority Health Cigna Priority Health $2.67
Rate for Payer: Priority Health Cigna Priority Health $3.07
Rate for Payer: Priority Health Cigna Priority Health $2.86
Rate for Payer: Priority Health HMO/PPO/Tiered Network $3.31
Rate for Payer: Priority Health HMO/PPO/Tiered Network $3.56
Rate for Payer: Priority Health HMO/PPO/Tiered Network $3.81
Rate for Payer: Priority Health Narrow/Tiered Network $2.32
Rate for Payer: Priority Health Narrow/Tiered Network $2.67
Rate for Payer: Priority Health Narrow/Tiered Network $2.49
Rate for Payer: UHC All Payor (Choice/PPO) $3.60
Rate for Payer: UHC All Payor (Choice/PPO) $3.85
Rate for Payer: UHC All Payor (Choice/PPO) $3.35
Rate for Payer: UHC Core $3.66
Rate for Payer: UHC Core $3.42
Rate for Payer: UHC Core $3.18
Rate for Payer: Van Buren County Sheriff Dept. Commercial $3.07
Rate for Payer: Van Buren County Sheriff Dept. Commercial $2.86
Rate for Payer: Van Buren County Sheriff Dept. Commercial $3.28
Service Code HCPCS J7611
Hospital Charge Code 115221
Hospital Revenue Code 250
Min. Negotiated Rate $2.05
Max. Negotiated Rate $3.02
Rate for Payer: Aetna Commercial $2.86
Rate for Payer: BCBS Trust/PPO $2.60
Rate for Payer: BCN Commercial $2.60
Rate for Payer: Cash Price $2.69
Rate for Payer: Cofinity Commercial $2.89
Rate for Payer: Encore Health Key Benefits Commercial $2.69
Rate for Payer: Healthscope Commercial $3.02
Rate for Payer: Lakeland Regional Health Systems Commercial $2.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $2.86
Rate for Payer: PHP Commercial $2.86
Rate for Payer: Priority Health Cigna Priority Health $2.35
Rate for Payer: Priority Health HMO/PPO/Tiered Network $2.92
Rate for Payer: Priority Health Narrow/Tiered Network $2.05
Rate for Payer: UHC All Payor (Choice/PPO) $2.96
Rate for Payer: UHC Core $2.81
Rate for Payer: Van Buren County Sheriff Dept. Commercial $2.52
Service Code NDC 9900-0011-69
Hospital Charge Code 300450
Hospital Revenue Code 637
Min. Negotiated Rate $66.60
Max. Negotiated Rate $98.28
Rate for Payer: Aetna Commercial $92.82
Rate for Payer: BCBS Trust/PPO $84.39
Rate for Payer: BCN Commercial $84.39
Rate for Payer: Cash Price $87.36
Rate for Payer: Cofinity Commercial $93.91
Rate for Payer: Encore Health Key Benefits Commercial $87.36
Rate for Payer: Healthscope Commercial $98.28
Rate for Payer: Lakeland Regional Health Systems Commercial $81.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $92.82
Rate for Payer: PHP Commercial $92.82
Rate for Payer: Priority Health Cigna Priority Health $76.44
Rate for Payer: Priority Health HMO/PPO/Tiered Network $95.00
Rate for Payer: Priority Health Narrow/Tiered Network $66.60
Rate for Payer: UHC All Payor (Choice/PPO) $96.10
Rate for Payer: UHC Core $91.18
Rate for Payer: Van Buren County Sheriff Dept. Commercial $81.90
Service Code NDC 68180-963-01
Hospital Charge Code 300450
Hospital Revenue Code 637
Min. Negotiated Rate $89.23
Max. Negotiated Rate $131.67
Rate for Payer: Aetna Commercial $124.36
Rate for Payer: BCBS Trust/PPO $113.06
Rate for Payer: BCN Commercial $113.06
Rate for Payer: Cash Price $117.04
Rate for Payer: Cofinity Commercial $125.82
Rate for Payer: Encore Health Key Benefits Commercial $117.04
Rate for Payer: Healthscope Commercial $131.67
Rate for Payer: Lakeland Regional Health Systems Commercial $109.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $124.36
Rate for Payer: PHP Commercial $124.36
Rate for Payer: Priority Health Cigna Priority Health $102.41
Rate for Payer: Priority Health HMO/PPO/Tiered Network $127.28
Rate for Payer: Priority Health Narrow/Tiered Network $89.23
Rate for Payer: UHC All Payor (Choice/PPO) $128.74
Rate for Payer: UHC Core $122.16
Rate for Payer: Van Buren County Sheriff Dept. Commercial $109.72
Service Code NDC 68180-963-01
Hospital Charge Code 17837
Hospital Revenue Code 637
Min. Negotiated Rate $89.23
Max. Negotiated Rate $131.67
Rate for Payer: Aetna Commercial $124.36
Rate for Payer: BCBS Trust/PPO $113.06
Rate for Payer: BCN Commercial $113.06
Rate for Payer: Cash Price $117.04
Rate for Payer: Cofinity Commercial $125.82
Rate for Payer: Encore Health Key Benefits Commercial $117.04
Rate for Payer: Healthscope Commercial $131.67
Rate for Payer: Lakeland Regional Health Systems Commercial $109.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $124.36
Rate for Payer: PHP Commercial $124.36
Rate for Payer: Priority Health Cigna Priority Health $102.41
Rate for Payer: Priority Health HMO/PPO/Tiered Network $127.28
Rate for Payer: Priority Health Narrow/Tiered Network $89.23
Rate for Payer: UHC All Payor (Choice/PPO) $128.74
Rate for Payer: UHC Core $122.16
Rate for Payer: Van Buren County Sheriff Dept. Commercial $109.72
Service Code NDC 53489-156-01
Hospital Charge Code 310
Hospital Revenue Code 637
Min. Negotiated Rate $154.79
Max. Negotiated Rate $228.42
Rate for Payer: Aetna Commercial $215.73
Rate for Payer: BCBS Trust/PPO $196.14
Rate for Payer: BCN Commercial $196.14
Rate for Payer: Cash Price $203.04
Rate for Payer: Cofinity Commercial $218.27
Rate for Payer: Encore Health Key Benefits Commercial $203.04
Rate for Payer: Healthscope Commercial $228.42
Rate for Payer: Lakeland Regional Health Systems Commercial $190.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $215.73
Rate for Payer: PHP Commercial $215.73
Rate for Payer: Priority Health Cigna Priority Health $177.66
Rate for Payer: Priority Health HMO/PPO/Tiered Network $220.81
Rate for Payer: Priority Health Narrow/Tiered Network $154.79
Rate for Payer: UHC All Payor (Choice/PPO) $223.34
Rate for Payer: UHC Core $211.92
Rate for Payer: Van Buren County Sheriff Dept. Commercial $190.35
Service Code NDC 0904-7041-61
Hospital Charge Code 310
Hospital Revenue Code 637
Min. Negotiated Rate $272.32
Max. Negotiated Rate $401.85
Rate for Payer: Aetna Commercial $379.52
Rate for Payer: BCBS Trust/PPO $345.06
Rate for Payer: BCN Commercial $345.06
Rate for Payer: Cash Price $357.20
Rate for Payer: Cofinity Commercial $383.99
Rate for Payer: Encore Health Key Benefits Commercial $357.20
Rate for Payer: Healthscope Commercial $401.85
Rate for Payer: Lakeland Regional Health Systems Commercial $334.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $379.52
Rate for Payer: PHP Commercial $379.52
Rate for Payer: Priority Health Cigna Priority Health $312.55
Rate for Payer: Priority Health HMO/PPO/Tiered Network $388.46
Rate for Payer: Priority Health Narrow/Tiered Network $272.32
Rate for Payer: UHC All Payor (Choice/PPO) $392.92
Rate for Payer: UHC Core $372.83
Rate for Payer: Van Buren County Sheriff Dept. Commercial $334.88
Service Code NDC 51079-205-01
Hospital Charge Code 310
Hospital Revenue Code 637
Min. Negotiated Rate $1.70
Max. Negotiated Rate $2.50
Rate for Payer: Aetna Commercial $2.36
Rate for Payer: BCBS Trust/PPO $2.15
Rate for Payer: BCN Commercial $2.15
Rate for Payer: Cash Price $2.22
Rate for Payer: Cofinity Commercial $2.39
Rate for Payer: Encore Health Key Benefits Commercial $2.22
Rate for Payer: Healthscope Commercial $2.50
Rate for Payer: Lakeland Regional Health Systems Commercial $2.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $2.36
Rate for Payer: PHP Commercial $2.36
Rate for Payer: Priority Health Cigna Priority Health $1.95
Rate for Payer: Priority Health HMO/PPO/Tiered Network $2.42
Rate for Payer: Priority Health Narrow/Tiered Network $1.70
Rate for Payer: UHC All Payor (Choice/PPO) $2.45
Rate for Payer: UHC Core $2.32
Rate for Payer: Van Buren County Sheriff Dept. Commercial $2.08
Service Code NDC 0378-0181-01
Hospital Charge Code 311
Hospital Revenue Code 637
Min. Negotiated Rate $155.16
Max. Negotiated Rate $228.96
Rate for Payer: Aetna Commercial $216.24
Rate for Payer: BCBS Trust/PPO $196.60
Rate for Payer: BCN Commercial $196.60
Rate for Payer: Cash Price $203.52
Rate for Payer: Cofinity Commercial $218.78
Rate for Payer: Encore Health Key Benefits Commercial $203.52
Rate for Payer: Healthscope Commercial $228.96
Rate for Payer: Lakeland Regional Health Systems Commercial $190.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $216.24
Rate for Payer: PHP Commercial $216.24
Rate for Payer: Priority Health Cigna Priority Health $178.08
Rate for Payer: Priority Health HMO/PPO/Tiered Network $221.33
Rate for Payer: Priority Health Narrow/Tiered Network $155.16
Rate for Payer: UHC All Payor (Choice/PPO) $223.87
Rate for Payer: UHC Core $212.42
Rate for Payer: Van Buren County Sheriff Dept. Commercial $190.80
Service Code NDC 0591-5544-01
Hospital Charge Code 311
Hospital Revenue Code 637
Min. Negotiated Rate $163.36
Max. Negotiated Rate $241.06
Rate for Payer: Aetna Commercial $227.66
Rate for Payer: BCBS Trust/PPO $206.99
Rate for Payer: BCN Commercial $206.99
Rate for Payer: Cash Price $214.27
Rate for Payer: Cofinity Commercial $230.34
Rate for Payer: Encore Health Key Benefits Commercial $214.27
Rate for Payer: Healthscope Commercial $241.06
Rate for Payer: Lakeland Regional Health Systems Commercial $200.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $227.66
Rate for Payer: PHP Commercial $227.66
Rate for Payer: Priority Health Cigna Priority Health $187.49
Rate for Payer: Priority Health HMO/PPO/Tiered Network $233.02
Rate for Payer: Priority Health Narrow/Tiered Network $163.36
Rate for Payer: UHC All Payor (Choice/PPO) $235.70
Rate for Payer: UHC Core $223.65
Rate for Payer: Van Buren County Sheriff Dept. Commercial $200.88
Service Code NDC 0904-6572-61
Hospital Charge Code 311
Hospital Revenue Code 637
Min. Negotiated Rate $198.74
Max. Negotiated Rate $293.26
Rate for Payer: Aetna Commercial $276.97
Rate for Payer: BCBS Trust/PPO $251.82
Rate for Payer: BCN Commercial $251.82
Rate for Payer: Cash Price $260.68
Rate for Payer: Cofinity Commercial $280.23
Rate for Payer: Encore Health Key Benefits Commercial $260.68
Rate for Payer: Healthscope Commercial $293.26
Rate for Payer: Lakeland Regional Health Systems Commercial $244.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $276.97
Rate for Payer: PHP Commercial $276.97
Rate for Payer: Priority Health Cigna Priority Health $228.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network $283.49
Rate for Payer: Priority Health Narrow/Tiered Network $198.74
Rate for Payer: UHC All Payor (Choice/PPO) $286.75
Rate for Payer: UHC Core $272.08
Rate for Payer: Van Buren County Sheriff Dept. Commercial $244.39
Service Code NDC 0603-2116-21
Hospital Charge Code 311
Hospital Revenue Code 637
Min. Negotiated Rate $166.87
Max. Negotiated Rate $246.24
Rate for Payer: Aetna Commercial $232.56
Rate for Payer: BCBS Trust/PPO $211.44
Rate for Payer: BCN Commercial $211.44
Rate for Payer: Cash Price $218.88
Rate for Payer: Cofinity Commercial $235.30
Rate for Payer: Encore Health Key Benefits Commercial $218.88
Rate for Payer: Healthscope Commercial $246.24
Rate for Payer: Lakeland Regional Health Systems Commercial $205.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $232.56
Rate for Payer: PHP Commercial $232.56
Rate for Payer: Priority Health Cigna Priority Health $191.52
Rate for Payer: Priority Health HMO/PPO/Tiered Network $238.03
Rate for Payer: Priority Health Narrow/Tiered Network $166.87
Rate for Payer: UHC All Payor (Choice/PPO) $240.77
Rate for Payer: UHC Core $228.46
Rate for Payer: Van Buren County Sheriff Dept. Commercial $205.20
Service Code NDC 65862-676-01
Hospital Charge Code 324
Hospital Revenue Code 637
Min. Negotiated Rate $39.49
Max. Negotiated Rate $58.28
Rate for Payer: Aetna Commercial $55.04
Rate for Payer: BCBS Trust/PPO $50.04
Rate for Payer: BCN Commercial $50.04
Rate for Payer: Cash Price $51.80
Rate for Payer: Cofinity Commercial $55.68
Rate for Payer: Encore Health Key Benefits Commercial $51.80
Rate for Payer: Healthscope Commercial $58.28
Rate for Payer: Lakeland Regional Health Systems Commercial $48.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $55.04
Rate for Payer: PHP Commercial $55.04
Rate for Payer: Priority Health Cigna Priority Health $45.32
Rate for Payer: Priority Health HMO/PPO/Tiered Network $56.33
Rate for Payer: Priority Health Narrow/Tiered Network $39.49
Rate for Payer: UHC All Payor (Choice/PPO) $56.98
Rate for Payer: UHC Core $54.07
Rate for Payer: Van Buren County Sheriff Dept. Commercial $48.56
Service Code NDC 0781-1061-01
Hospital Charge Code 324
Hospital Revenue Code 637
Min. Negotiated Rate $28.82
Max. Negotiated Rate $42.52
Rate for Payer: Aetna Commercial $40.16
Rate for Payer: BCBS Trust/PPO $36.51
Rate for Payer: BCN Commercial $36.51
Rate for Payer: Cash Price $37.80
Rate for Payer: Cofinity Commercial $40.64
Rate for Payer: Encore Health Key Benefits Commercial $37.80
Rate for Payer: Healthscope Commercial $42.52
Rate for Payer: Lakeland Regional Health Systems Commercial $35.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $40.16
Rate for Payer: PHP Commercial $40.16
Rate for Payer: Priority Health Cigna Priority Health $33.08
Rate for Payer: Priority Health HMO/PPO/Tiered Network $41.11
Rate for Payer: Priority Health Narrow/Tiered Network $28.82
Rate for Payer: UHC All Payor (Choice/PPO) $41.58
Rate for Payer: UHC Core $39.45
Rate for Payer: Van Buren County Sheriff Dept. Commercial $35.44
Service Code NDC 65862-677-01
Hospital Charge Code 325
Hospital Revenue Code 637
Min. Negotiated Rate $35.22
Max. Negotiated Rate $51.98
Rate for Payer: Aetna Commercial $49.09
Rate for Payer: BCBS Trust/PPO $44.63
Rate for Payer: BCN Commercial $44.63
Rate for Payer: Cash Price $46.20
Rate for Payer: Cofinity Commercial $49.66
Rate for Payer: Encore Health Key Benefits Commercial $46.20
Rate for Payer: Healthscope Commercial $51.98
Rate for Payer: Lakeland Regional Health Systems Commercial $43.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $49.09
Rate for Payer: PHP Commercial $49.09
Rate for Payer: Priority Health Cigna Priority Health $40.42
Rate for Payer: Priority Health HMO/PPO/Tiered Network $50.24
Rate for Payer: Priority Health Narrow/Tiered Network $35.22
Rate for Payer: UHC All Payor (Choice/PPO) $50.82
Rate for Payer: UHC Core $48.22
Rate for Payer: Van Buren County Sheriff Dept. Commercial $43.31
Service Code NDC 65862-678-01
Hospital Charge Code 326
Hospital Revenue Code 637
Min. Negotiated Rate $53.03
Max. Negotiated Rate $78.26
Rate for Payer: Aetna Commercial $73.91
Rate for Payer: BCBS Trust/PPO $67.19
Rate for Payer: BCN Commercial $67.19
Rate for Payer: Cash Price $69.56
Rate for Payer: Cofinity Commercial $74.78
Rate for Payer: Encore Health Key Benefits Commercial $69.56
Rate for Payer: Healthscope Commercial $78.26
Rate for Payer: Lakeland Regional Health Systems Commercial $65.21
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $73.91
Rate for Payer: PHP Commercial $73.91
Rate for Payer: Priority Health Cigna Priority Health $60.86
Rate for Payer: Priority Health HMO/PPO/Tiered Network $75.65
Rate for Payer: Priority Health Narrow/Tiered Network $53.03
Rate for Payer: UHC All Payor (Choice/PPO) $76.52
Rate for Payer: UHC Core $72.60
Rate for Payer: Van Buren County Sheriff Dept. Commercial $65.21
Service Code HCPCS J2997
Hospital Charge Code 9002
Hospital Revenue Code 636
Min. Negotiated Rate $17,587.08
Max. Negotiated Rate $25,952.40
Rate for Payer: Aetna Commercial $24,510.60
Rate for Payer: BCBS Trust/PPO $22,284.46
Rate for Payer: BCN Commercial $22,284.46
Rate for Payer: Cash Price $23,068.80
Rate for Payer: Cofinity Commercial $24,798.96
Rate for Payer: Encore Health Key Benefits Commercial $23,068.80
Rate for Payer: Healthscope Commercial $25,952.40
Rate for Payer: Lakeland Regional Health Systems Commercial $21,627.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $24,510.60
Rate for Payer: PHP Commercial $24,510.60
Rate for Payer: Priority Health Cigna Priority Health $20,185.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $25,087.32
Rate for Payer: Priority Health Narrow/Tiered Network $17,587.08
Rate for Payer: UHC All Payor (Choice/PPO) $25,375.68
Rate for Payer: UHC Core $24,078.06
Rate for Payer: Van Buren County Sheriff Dept. Commercial $21,627.00
Service Code HCPCS J2997
Hospital Charge Code 150807
Hospital Revenue Code 636
Min. Negotiated Rate $17,587.08
Max. Negotiated Rate $25,952.40
Rate for Payer: Aetna Commercial $24,510.60
Rate for Payer: BCBS Trust/PPO $22,284.46
Rate for Payer: BCN Commercial $22,284.46
Rate for Payer: Cash Price $23,068.80
Rate for Payer: Cofinity Commercial $24,798.96
Rate for Payer: Encore Health Key Benefits Commercial $23,068.80
Rate for Payer: Healthscope Commercial $25,952.40
Rate for Payer: Lakeland Regional Health Systems Commercial $21,627.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $24,510.60
Rate for Payer: PHP Commercial $24,510.60
Rate for Payer: Priority Health Cigna Priority Health $20,185.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $25,087.32
Rate for Payer: Priority Health Narrow/Tiered Network $17,587.08
Rate for Payer: UHC All Payor (Choice/PPO) $25,375.68
Rate for Payer: UHC Core $24,078.06
Rate for Payer: Van Buren County Sheriff Dept. Commercial $21,627.00
Service Code HCPCS J2997
Hospital Charge Code 150806
Hospital Revenue Code 636
Min. Negotiated Rate $17,587.08
Max. Negotiated Rate $25,952.40
Rate for Payer: Aetna Commercial $24,510.60
Rate for Payer: BCBS Trust/PPO $22,284.46
Rate for Payer: BCN Commercial $22,284.46
Rate for Payer: Cash Price $23,068.80
Rate for Payer: Cofinity Commercial $24,798.96
Rate for Payer: Encore Health Key Benefits Commercial $23,068.80
Rate for Payer: Healthscope Commercial $25,952.40
Rate for Payer: Lakeland Regional Health Systems Commercial $21,627.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $24,510.60
Rate for Payer: PHP Commercial $24,510.60
Rate for Payer: Priority Health Cigna Priority Health $20,185.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $25,087.32
Rate for Payer: Priority Health Narrow/Tiered Network $17,587.08
Rate for Payer: UHC All Payor (Choice/PPO) $25,375.68
Rate for Payer: UHC Core $24,078.06
Rate for Payer: Van Buren County Sheriff Dept. Commercial $21,627.00
Service Code HCPCS J2997
Hospital Charge Code 31310
Hospital Revenue Code 636
Min. Negotiated Rate $355.11
Max. Negotiated Rate $524.02
Rate for Payer: Aetna Commercial $494.90
Rate for Payer: BCBS Trust/PPO $449.96
Rate for Payer: BCN Commercial $449.96
Rate for Payer: Cash Price $465.79
Rate for Payer: Cofinity Commercial $500.73
Rate for Payer: Encore Health Key Benefits Commercial $465.79
Rate for Payer: Healthscope Commercial $524.02
Rate for Payer: Lakeland Regional Health Systems Commercial $436.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $494.90
Rate for Payer: PHP Commercial $494.90
Rate for Payer: Priority Health Cigna Priority Health $407.57
Rate for Payer: Priority Health HMO/PPO/Tiered Network $506.55
Rate for Payer: Priority Health Narrow/Tiered Network $355.11
Rate for Payer: UHC All Payor (Choice/PPO) $512.37
Rate for Payer: UHC Core $486.17
Rate for Payer: Van Buren County Sheriff Dept. Commercial $436.68
Service Code HCPCS J2997
Hospital Charge Code 9003
Hospital Revenue Code 636
Min. Negotiated Rate $8,793.54
Max. Negotiated Rate $12,976.20
Rate for Payer: Aetna Commercial $12,255.30
Rate for Payer: BCBS Trust/PPO $11,142.23
Rate for Payer: BCN Commercial $11,142.23
Rate for Payer: Cash Price $11,534.40
Rate for Payer: Cofinity Commercial $12,399.48
Rate for Payer: Encore Health Key Benefits Commercial $11,534.40
Rate for Payer: Healthscope Commercial $12,976.20
Rate for Payer: Lakeland Regional Health Systems Commercial $10,813.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $12,255.30
Rate for Payer: PHP Commercial $12,255.30
Rate for Payer: Priority Health Cigna Priority Health $10,092.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network $12,543.66
Rate for Payer: Priority Health Narrow/Tiered Network $8,793.54
Rate for Payer: UHC All Payor (Choice/PPO) $12,687.84
Rate for Payer: UHC Core $12,039.03
Rate for Payer: Van Buren County Sheriff Dept. Commercial $10,813.50
Service Code HCPCS J2997
Hospital Charge Code 300766
Hospital Revenue Code 636
Min. Negotiated Rate $8,793.54
Max. Negotiated Rate $12,976.20
Rate for Payer: Aetna Commercial $12,255.30
Rate for Payer: BCBS Trust/PPO $11,142.23
Rate for Payer: BCN Commercial $11,142.23
Rate for Payer: Cash Price $11,534.40
Rate for Payer: Cofinity Commercial $12,399.48
Rate for Payer: Encore Health Key Benefits Commercial $11,534.40
Rate for Payer: Healthscope Commercial $12,976.20
Rate for Payer: Lakeland Regional Health Systems Commercial $10,813.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $12,255.30
Rate for Payer: PHP Commercial $12,255.30
Rate for Payer: Priority Health Cigna Priority Health $10,092.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network $12,543.66
Rate for Payer: Priority Health Narrow/Tiered Network $8,793.54
Rate for Payer: UHC All Payor (Choice/PPO) $12,687.84
Rate for Payer: UHC Core $12,039.03
Rate for Payer: Van Buren County Sheriff Dept. Commercial $10,813.50
Service Code NDC 9900-0001-91
Hospital Charge Code 38285
Hospital Revenue Code 637
Min. Negotiated Rate $6.64
Max. Negotiated Rate $9.79
Rate for Payer: Aetna Commercial $9.25
Rate for Payer: BCBS Trust/PPO $8.41
Rate for Payer: BCN Commercial $8.41
Rate for Payer: Cash Price $8.70
Rate for Payer: Cofinity Commercial $9.36
Rate for Payer: Encore Health Key Benefits Commercial $8.70
Rate for Payer: Healthscope Commercial $9.79
Rate for Payer: Lakeland Regional Health Systems Commercial $8.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $9.25
Rate for Payer: PHP Commercial $9.25
Rate for Payer: Priority Health Cigna Priority Health $7.62
Rate for Payer: Priority Health HMO/PPO/Tiered Network $9.47
Rate for Payer: Priority Health Narrow/Tiered Network $6.64
Rate for Payer: UHC All Payor (Choice/PPO) $9.57
Rate for Payer: UHC Core $9.08
Rate for Payer: Van Buren County Sheriff Dept. Commercial $8.16