|
HC HEPATITIS BE ANTIGEN
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 87350
|
| Hospital Charge Code |
30600142
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: BCBS Trust/PPO |
$73.89
|
| Rate for Payer: BCN Commercial |
$73.89
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.10
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC HEPATITIS BE ANTIGEN
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 87350
|
| Hospital Charge Code |
30600142
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.77 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$23.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.96
|
| Rate for Payer: BCBS Complete |
$16.56
|
| Rate for Payer: BCBS MAPPO |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$73.55
|
| Rate for Payer: BCN Medicare Advantage |
$22.37
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Mclaren Medicaid |
$15.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.49
|
| Rate for Payer: Meridian Medicaid |
$16.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.10
|
| Rate for Payer: PACE Senior Care Partners |
$21.25
|
| Rate for Payer: PACE SWMI |
$22.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$22.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Medicare |
$22.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.27
|
| Rate for Payer: Railroad Medicare Medicare |
$22.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: UHC Exchange |
$22.37
|
| Rate for Payer: UHC Medicaid |
$15.77
|
| Rate for Payer: UHC Medicare Advantage |
$22.37
|
| Rate for Payer: UHCCP Medicaid |
$15.77
|
| Rate for Payer: VA VA |
$22.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC HEPATITIS B SURFACE ANTIBODY
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 86706
|
| Hospital Charge Code |
30200296
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HEPATITIS B SURFACE ANTIBODY
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 86706
|
| Hospital Charge Code |
30200296
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HEPATITIS B SURFACE ANTIGEN
|
Facility
|
IP
|
$39.63
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600139
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.58 |
| Max. Negotiated Rate |
$35.67 |
| Rate for Payer: Aetna Commercial |
$33.69
|
| Rate for Payer: BCBS Trust/PPO |
$32.73
|
| Rate for Payer: BCN Commercial |
$32.73
|
| Rate for Payer: Cash Price |
$31.70
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.70
|
| Rate for Payer: Healthscope Commercial |
$35.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.69
|
| Rate for Payer: Nomi Health Commercial |
$32.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.72
|
| Rate for Payer: PHP Commercial |
$33.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.87
|
| Rate for Payer: UHC Core |
$33.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.72
|
|
|
HC HEPATITIS B SURFACE ANTIGEN
|
Facility
|
OP
|
$39.63
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600139
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$35.67 |
| Rate for Payer: Aetna Commercial |
$33.69
|
| Rate for Payer: Aetna Medicare |
$10.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.38
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$9.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.58
|
| Rate for Payer: BCN Commercial |
$32.58
|
| Rate for Payer: BCN Medicare Advantage |
$9.91
|
| Rate for Payer: Cash Price |
$31.70
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.91
|
| Rate for Payer: Healthscope Commercial |
$35.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.72
|
| Rate for Payer: Mclaren Medicaid |
$6.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Medicaid |
$7.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.69
|
| Rate for Payer: Nomi Health Commercial |
$32.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.72
|
| Rate for Payer: PACE Senior Care Partners |
$9.41
|
| Rate for Payer: PACE SWMI |
$9.91
|
| Rate for Payer: PHP Commercial |
$33.69
|
| Rate for Payer: PHP Medicare Advantage |
$9.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.48
|
| Rate for Payer: Priority Health Medicare |
$10.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.58
|
| Rate for Payer: Railroad Medicare Medicare |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.87
|
| Rate for Payer: UHC Core |
$33.09
|
| Rate for Payer: UHC Exchange |
$9.91
|
| Rate for Payer: UHC Medicaid |
$6.99
|
| Rate for Payer: UHC Medicare Advantage |
$9.91
|
| Rate for Payer: UHCCP Medicaid |
$6.99
|
| Rate for Payer: VA VA |
$9.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.72
|
|
|
HC HEPATITIS B SURFACE ANTIGEN NEUTRALIZATION
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 87341
|
| Hospital Charge Code |
30600141
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.86 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: BCBS Trust/PPO |
$62.73
|
| Rate for Payer: BCN Commercial |
$62.73
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.96
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.84
|
| Rate for Payer: UHC Core |
$63.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC HEPATITIS B SURFACE ANTIGEN NEUTRALIZATION
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 87341
|
| Hospital Charge Code |
30600141
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$19.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.73
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$18.99
|
| Rate for Payer: BCBS Trust/PPO |
$62.44
|
| Rate for Payer: BCN Commercial |
$62.44
|
| Rate for Payer: BCN Medicare Advantage |
$18.99
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.99
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.94
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.96
|
| Rate for Payer: PACE Senior Care Partners |
$18.04
|
| Rate for Payer: PACE SWMI |
$18.99
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: PHP Medicare Advantage |
$18.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$19.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.86
|
| Rate for Payer: Railroad Medicare Medicare |
$18.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.84
|
| Rate for Payer: UHC Core |
$63.42
|
| Rate for Payer: UHC Exchange |
$18.99
|
| Rate for Payer: UHC Medicaid |
$13.39
|
| Rate for Payer: UHC Medicare Advantage |
$18.99
|
| Rate for Payer: UHCCP Medicaid |
$13.39
|
| Rate for Payer: VA VA |
$18.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC HEPATITIS B VACCINE ADULT, 3 DOSE IM
|
Facility
|
IP
|
$85.96
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
63600026
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.83 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.64
|
| Rate for Payer: UHC Core |
$71.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC HEPATITIS B VACCINE ADULT, 3 DOSE IM
|
Facility
|
OP
|
$85.96
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
63600026
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: Aetna Medicare |
$22.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.86
|
| Rate for Payer: BCBS Complete |
$15.91
|
| Rate for Payer: BCBS MAPPO |
$21.49
|
| Rate for Payer: BCBS Trust/PPO |
$70.67
|
| Rate for Payer: BCN Commercial |
$70.67
|
| Rate for Payer: BCN Medicare Advantage |
$21.49
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.49
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Mclaren Medicaid |
$15.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.56
|
| Rate for Payer: Meridian Medicaid |
$15.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: PACE Senior Care Partners |
$20.42
|
| Rate for Payer: PACE SWMI |
$21.49
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: PHP Medicare Advantage |
$21.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.79
|
| Rate for Payer: Priority Health Medicare |
$21.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.83
|
| Rate for Payer: Railroad Medicare Medicare |
$21.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.64
|
| Rate for Payer: UHC Core |
$71.78
|
| Rate for Payer: UHC Exchange |
$21.49
|
| Rate for Payer: UHC Medicaid |
$15.15
|
| Rate for Payer: UHC Medicare Advantage |
$21.49
|
| Rate for Payer: UHCCP Medicaid |
$15.15
|
| Rate for Payer: VA VA |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC HEPATITIS B VIRUS E ANTIBODY, SERUM
|
Facility
|
OP
|
$41.82
|
|
|
Service Code
|
CPT 86707
|
| Hospital Charge Code |
30200516
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.37 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$10.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.07
|
| Rate for Payer: BCBS Complete |
$7.74
|
| Rate for Payer: BCBS MAPPO |
$10.46
|
| Rate for Payer: BCBS Trust/PPO |
$34.38
|
| Rate for Payer: BCN Commercial |
$34.38
|
| Rate for Payer: BCN Medicare Advantage |
$10.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Mclaren Medicaid |
$7.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.98
|
| Rate for Payer: Meridian Medicaid |
$7.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.36
|
| Rate for Payer: PACE Senior Care Partners |
$9.93
|
| Rate for Payer: PACE SWMI |
$10.46
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.38
|
| Rate for Payer: Priority Health Medicare |
$10.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: Railroad Medicare Medicare |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: UHC Exchange |
$10.46
|
| Rate for Payer: UHC Medicaid |
$7.37
|
| Rate for Payer: UHC Medicare Advantage |
$10.46
|
| Rate for Payer: UHCCP Medicaid |
$7.37
|
| Rate for Payer: VA VA |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC HEPATITIS B VIRUS E ANTIBODY, SERUM
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 86707
|
| Hospital Charge Code |
30200516
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.11 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: BCBS Trust/PPO |
$34.54
|
| Rate for Payer: BCN Commercial |
$34.54
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.36
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC HEPATITIS B VIRUS E ANTIGEN, SERUM
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 87350
|
| Hospital Charge Code |
30600351
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.54
|
| Rate for Payer: BCN Commercial |
$33.54
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: Meridian Medicaid |
$7.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.40
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHC Medicare Advantage |
$10.20
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC HEPATITIS B VIRUS E ANTIGEN, SERUM
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 87350
|
| Hospital Charge Code |
30600351
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$33.70
|
| Rate for Payer: BCN Commercial |
$33.70
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.60
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC HEPATITIS B VIRUS SURFACE ANTIGEN, SERUM
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600350
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$33.70
|
| Rate for Payer: BCN Commercial |
$33.70
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.60
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC HEPATITIS B VIRUS SURFACE ANTIGEN, SERUM
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600350
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.54
|
| Rate for Payer: BCN Commercial |
$33.54
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: Meridian Medicaid |
$7.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.40
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHC Medicare Advantage |
$10.20
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC HEPATITIS C ANTIBODY
|
Facility
|
OP
|
$50.21
|
|
|
Service Code
|
CPT 86803
|
| Hospital Charge Code |
30200336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$45.19 |
| Rate for Payer: Aetna Commercial |
$42.68
|
| Rate for Payer: Aetna Medicare |
$13.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.69
|
| Rate for Payer: BCBS Complete |
$9.29
|
| Rate for Payer: BCBS MAPPO |
$12.55
|
| Rate for Payer: BCBS Trust/PPO |
$41.28
|
| Rate for Payer: BCN Commercial |
$41.28
|
| Rate for Payer: BCN Medicare Advantage |
$12.55
|
| Rate for Payer: Cash Price |
$40.17
|
| Rate for Payer: Cofinity Commercial |
$43.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$45.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.66
|
| Rate for Payer: Mclaren Medicaid |
$8.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.18
|
| Rate for Payer: Meridian Medicaid |
$9.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.68
|
| Rate for Payer: Nomi Health Commercial |
$41.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.66
|
| Rate for Payer: PACE Senior Care Partners |
$11.92
|
| Rate for Payer: PACE SWMI |
$12.55
|
| Rate for Payer: PHP Commercial |
$42.68
|
| Rate for Payer: PHP Medicare Advantage |
$12.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.68
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.95
|
| Rate for Payer: Railroad Medicare Medicare |
$12.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.18
|
| Rate for Payer: UHC Core |
$41.93
|
| Rate for Payer: UHC Exchange |
$12.55
|
| Rate for Payer: UHC Medicaid |
$8.85
|
| Rate for Payer: UHC Medicare Advantage |
$12.55
|
| Rate for Payer: UHCCP Medicaid |
$8.85
|
| Rate for Payer: VA VA |
$12.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.66
|
|
|
HC HEPATITIS C ANTIBODY
|
Facility
|
IP
|
$50.21
|
|
|
Service Code
|
CPT 86803
|
| Hospital Charge Code |
30200336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.95 |
| Max. Negotiated Rate |
$45.19 |
| Rate for Payer: Aetna Commercial |
$42.68
|
| Rate for Payer: BCBS Trust/PPO |
$41.47
|
| Rate for Payer: BCN Commercial |
$41.47
|
| Rate for Payer: Cash Price |
$40.17
|
| Rate for Payer: Cofinity Commercial |
$43.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.17
|
| Rate for Payer: Healthscope Commercial |
$45.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.68
|
| Rate for Payer: Nomi Health Commercial |
$41.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.66
|
| Rate for Payer: PHP Commercial |
$42.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.18
|
| Rate for Payer: UHC Core |
$41.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.66
|
|
|
HC HEPATITIS C ANTIBODY BY RIBA
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 86804
|
| Hospital Charge Code |
30200337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.86 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$21.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.33
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$21.07
|
| Rate for Payer: BCBS Trust/PPO |
$69.28
|
| Rate for Payer: BCN Commercial |
$69.28
|
| Rate for Payer: BCN Medicare Advantage |
$21.07
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.07
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Mclaren Medicaid |
$14.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.12
|
| Rate for Payer: Meridian Medicaid |
$15.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: PACE Senior Care Partners |
$20.01
|
| Rate for Payer: PACE SWMI |
$21.07
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: PHP Medicare Advantage |
$21.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.31
|
| Rate for Payer: Priority Health Medicare |
$21.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.65
|
| Rate for Payer: Railroad Medicare Medicare |
$21.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.16
|
| Rate for Payer: UHC Core |
$70.37
|
| Rate for Payer: UHC Exchange |
$21.07
|
| Rate for Payer: UHC Medicaid |
$14.86
|
| Rate for Payer: UHC Medicare Advantage |
$21.07
|
| Rate for Payer: UHCCP Medicaid |
$14.86
|
| Rate for Payer: VA VA |
$21.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC HEPATITIS C ANTIBODY BY RIBA
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 86804
|
| Hospital Charge Code |
30200337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.65 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: BCBS Trust/PPO |
$69.60
|
| Rate for Payer: BCN Commercial |
$69.60
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.16
|
| Rate for Payer: UHC Core |
$70.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna Medicare |
$40.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.75
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$39.00
|
| Rate for Payer: BCBS Trust/PPO |
$128.25
|
| Rate for Payer: BCN Commercial |
$128.25
|
| Rate for Payer: BCN Medicare Advantage |
$39.00
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.00
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.95
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$127.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PACE Senior Care Partners |
$37.05
|
| Rate for Payer: PACE SWMI |
$39.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: PHP Medicare Advantage |
$39.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$39.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.58
|
| Rate for Payer: Railroad Medicare Medicare |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$130.26
|
| Rate for Payer: UHC Exchange |
$39.00
|
| Rate for Payer: UHC Medicaid |
$27.50
|
| Rate for Payer: UHC Medicare Advantage |
$39.00
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$39.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$108.58 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: BCBS Trust/PPO |
$128.84
|
| Rate for Payer: BCN Commercial |
$128.84
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$127.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$130.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna Medicare |
$40.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.75
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$39.00
|
| Rate for Payer: BCBS Trust/PPO |
$128.25
|
| Rate for Payer: BCN Commercial |
$128.25
|
| Rate for Payer: BCN Medicare Advantage |
$39.00
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.00
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.95
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$127.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PACE Senior Care Partners |
$37.05
|
| Rate for Payer: PACE SWMI |
$39.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: PHP Medicare Advantage |
$39.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$39.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.58
|
| Rate for Payer: Railroad Medicare Medicare |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$130.26
|
| Rate for Payer: UHC Exchange |
$39.00
|
| Rate for Payer: UHC Medicaid |
$27.50
|
| Rate for Payer: UHC Medicare Advantage |
$39.00
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$39.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$108.58 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: BCBS Trust/PPO |
$128.84
|
| Rate for Payer: BCN Commercial |
$128.84
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$127.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$130.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$9.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.61
|
| Rate for Payer: BCBS Complete |
$6.87
|
| Rate for Payer: BCBS MAPPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$30.53
|
| Rate for Payer: BCN Commercial |
$30.53
|
| Rate for Payer: BCN Medicare Advantage |
$9.29
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.29
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.75
|
| Rate for Payer: Meridian Medicaid |
$6.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.82
|
| Rate for Payer: PACE SWMI |
$9.29
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: PHP Medicare Advantage |
$9.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.31
|
| Rate for Payer: Priority Health Medicare |
$9.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.85
|
| Rate for Payer: Railroad Medicare Medicare |
$9.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.68
|
| Rate for Payer: UHC Core |
$31.01
|
| Rate for Payer: UHC Exchange |
$9.29
|
| Rate for Payer: UHC Medicaid |
$6.55
|
| Rate for Payer: UHC Medicare Advantage |
$9.29
|
| Rate for Payer: UHCCP Medicaid |
$6.55
|
| Rate for Payer: VA VA |
$9.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
