|
HC HERPES SIMPLEX IGM TYPE 1&2
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200278
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.20
|
| Rate for Payer: BCN Commercial |
$41.20
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC HERPES SIMPLEX IGM TYPE 1&2
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200278
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$12.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.47
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.09
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Senior Care Partners |
$11.85
|
| Rate for Payer: PACE SWMI |
$12.47
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Medicare |
$12.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: UHC Exchange |
$12.47
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$12.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC HERPES SIMPLEX NON-SPECIFIC
|
Facility
|
IP
|
$40.33
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200277
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$36.30 |
| Rate for Payer: Aetna Commercial |
$34.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$34.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Healthscope Commercial |
$36.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.28
|
| Rate for Payer: Nomi Health Commercial |
$33.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.25
|
| Rate for Payer: PHP Commercial |
$34.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.49
|
| Rate for Payer: UHC Core |
$33.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.25
|
|
|
HC HERPES SIMPLEX NON-SPECIFIC
|
Facility
|
OP
|
$40.33
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200277
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.11 |
| Max. Negotiated Rate |
$36.30 |
| Rate for Payer: Aetna Commercial |
$34.28
|
| Rate for Payer: Aetna Medicare |
$10.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.60
|
| Rate for Payer: BCBS Complete |
$7.47
|
| Rate for Payer: BCBS MAPPO |
$10.08
|
| Rate for Payer: BCBS Trust/PPO |
$33.16
|
| Rate for Payer: BCN Commercial |
$33.16
|
| Rate for Payer: BCN Medicare Advantage |
$10.08
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$34.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.08
|
| Rate for Payer: Healthscope Commercial |
$36.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.25
|
| Rate for Payer: Mclaren Medicaid |
$7.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.59
|
| Rate for Payer: Meridian Medicaid |
$7.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.28
|
| Rate for Payer: Nomi Health Commercial |
$33.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.25
|
| Rate for Payer: PACE Senior Care Partners |
$9.58
|
| Rate for Payer: PACE SWMI |
$10.08
|
| Rate for Payer: PHP Commercial |
$34.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.49
|
| Rate for Payer: UHC Core |
$33.68
|
| Rate for Payer: UHC Exchange |
$10.08
|
| Rate for Payer: UHC Medicaid |
$7.11
|
| Rate for Payer: UHC Medicare Advantage |
$10.08
|
| Rate for Payer: UHCCP Medicaid |
$7.11
|
| Rate for Payer: VA VA |
$10.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.25
|
|
|
HC HERPES SIMPLEX PCR
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC HERPES SIMPLEX PCR
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$51.88
|
| Rate for Payer: BCN Commercial |
$51.88
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC HERPES SIMPLEX VIRUS 1 (HSV-1)
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600270
|
|
Hospital Revenue Code
|
306
|
| 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 HERPES SIMPLEX VIRUS 1 (HSV-1)
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600270
|
|
Hospital Revenue Code
|
306
|
| 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 HERPES SIMPLEX VIRUS CULTURE
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 87255
|
| Hospital Charge Code |
30600116
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$87.64
|
| Rate for Payer: BCN Commercial |
$87.64
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC HERPES SIMPLEX VIRUS CULTURE
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 87255
|
| Hospital Charge Code |
30600116
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.71 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: BCBS Complete |
$19.64
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$87.24
|
| Rate for Payer: BCN Commercial |
$87.24
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$18.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.86
|
| Rate for Payer: Meridian Medicaid |
$19.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.86
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Medicaid |
$18.71
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: UHCCP Medicaid |
$18.71
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC HERPES SIMPLEX VIRUS (HSV-2)
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600271
|
|
Hospital Revenue Code
|
306
|
| 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 HERPES SIMPLEX VIRUS (HSV-2)
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600271
|
|
Hospital Revenue Code
|
306
|
| 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 HERPES SIMPLEX VIRUS PCR, BLD
|
Facility
|
OP
|
$49.51
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600340
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$44.56 |
| Rate for Payer: Aetna Commercial |
$42.08
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.47
|
| Rate for Payer: BCBS Complete |
$9.16
|
| Rate for Payer: BCBS MAPPO |
$12.38
|
| Rate for Payer: BCBS Trust/PPO |
$40.70
|
| Rate for Payer: BCN Commercial |
$40.70
|
| Rate for Payer: BCN Medicare Advantage |
$12.38
|
| Rate for Payer: Cash Price |
$39.61
|
| Rate for Payer: Cofinity Commercial |
$42.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$44.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.13
|
| Rate for Payer: Mclaren Medicaid |
$8.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.00
|
| Rate for Payer: Meridian Medicaid |
$9.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.08
|
| Rate for Payer: Nomi Health Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.13
|
| Rate for Payer: PACE Senior Care Partners |
$11.76
|
| Rate for Payer: PACE SWMI |
$12.38
|
| Rate for Payer: PHP Commercial |
$42.08
|
| Rate for Payer: PHP Medicare Advantage |
$12.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.07
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.46
|
| Rate for Payer: Railroad Medicare Medicare |
$12.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.57
|
| Rate for Payer: UHC Core |
$41.34
|
| Rate for Payer: UHC Exchange |
$12.38
|
| Rate for Payer: UHC Medicaid |
$8.73
|
| Rate for Payer: UHC Medicare Advantage |
$12.38
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
| Rate for Payer: VA VA |
$12.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.13
|
|
|
HC HERPES SIMPLEX VIRUS PCR, BLD
|
Facility
|
IP
|
$49.51
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600340
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$44.56 |
| Rate for Payer: Aetna Commercial |
$42.08
|
| Rate for Payer: BCBS Trust/PPO |
$40.89
|
| Rate for Payer: BCN Commercial |
$40.89
|
| Rate for Payer: Cash Price |
$39.61
|
| Rate for Payer: Cofinity Commercial |
$42.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.61
|
| Rate for Payer: Healthscope Commercial |
$44.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.08
|
| Rate for Payer: Nomi Health Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.13
|
| Rate for Payer: PHP Commercial |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.57
|
| Rate for Payer: UHC Core |
$41.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.13
|
|
|
HC HH ALOE VESTA CLEANSER
|
Facility
|
IP
|
$18.43
|
|
| Hospital Charge Code |
27100003
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.83 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: BCBS Trust/PPO |
$15.22
|
| Rate for Payer: BCN Commercial |
$15.22
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
HC HH ALOE VESTA CLEANSER
|
Facility
|
OP
|
$18.43
|
|
| Hospital Charge Code |
27100003
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.76
|
| Rate for Payer: BCBS Complete |
$3.41
|
| Rate for Payer: BCBS MAPPO |
$4.61
|
| Rate for Payer: BCBS Trust/PPO |
$15.15
|
| Rate for Payer: BCN Commercial |
$15.15
|
| Rate for Payer: BCN Medicare Advantage |
$4.61
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.61
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Mclaren Medicaid |
$3.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.84
|
| Rate for Payer: Meridian Medicaid |
$3.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.82
|
| Rate for Payer: PACE Senior Care Partners |
$4.38
|
| Rate for Payer: PACE SWMI |
$4.61
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: PHP Medicare Advantage |
$4.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Railroad Medicare Medicare |
$4.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: UHC Exchange |
$4.61
|
| Rate for Payer: UHC Medicaid |
$3.25
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: UHCCP Medicaid |
$3.25
|
| Rate for Payer: VA VA |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
HC HH POUCH CLOSURE CLAMP
|
Facility
|
OP
|
$17.17
|
|
| Hospital Charge Code |
27000138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$15.45 |
| Rate for Payer: Aetna Commercial |
$14.59
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.37
|
| Rate for Payer: BCBS Complete |
$3.18
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$14.12
|
| Rate for Payer: BCN Commercial |
$14.12
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cofinity Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$15.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.88
|
| Rate for Payer: Mclaren Medicaid |
$3.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.51
|
| Rate for Payer: Meridian Medicaid |
$3.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.59
|
| Rate for Payer: Nomi Health Commercial |
$14.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.88
|
| Rate for Payer: PACE Senior Care Partners |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$14.59
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.94
|
| Rate for Payer: Priority Health Medicare |
$4.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.95
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.11
|
| Rate for Payer: UHC Core |
$14.34
|
| Rate for Payer: UHC Exchange |
$4.29
|
| Rate for Payer: UHC Medicaid |
$3.03
|
| Rate for Payer: UHC Medicare Advantage |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$3.03
|
| Rate for Payer: VA VA |
$4.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.88
|
|
|
HC HH POUCH CLOSURE CLAMP
|
Facility
|
IP
|
$17.17
|
|
| Hospital Charge Code |
27000138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$15.45 |
| Rate for Payer: Aetna Commercial |
$14.59
|
| Rate for Payer: BCBS Trust/PPO |
$14.18
|
| Rate for Payer: BCN Commercial |
$14.18
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cofinity Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$15.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.59
|
| Rate for Payer: Nomi Health Commercial |
$14.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.88
|
| Rate for Payer: PHP Commercial |
$14.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.11
|
| Rate for Payer: UHC Core |
$14.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.88
|
|
|
HC HH WET ONES
|
Facility
|
IP
|
$16.37
|
|
| Hospital Charge Code |
27000170
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$14.73 |
| Rate for Payer: Aetna Commercial |
$13.91
|
| Rate for Payer: BCBS Trust/PPO |
$13.52
|
| Rate for Payer: BCN Commercial |
$13.52
|
| Rate for Payer: Cash Price |
$13.10
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$14.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.91
|
| Rate for Payer: Nomi Health Commercial |
$13.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.28
|
| Rate for Payer: PHP Commercial |
$13.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.41
|
| Rate for Payer: UHC Core |
$13.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.28
|
|
|
HC HH WET ONES
|
Facility
|
OP
|
$16.37
|
|
| Hospital Charge Code |
27000170
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$14.73 |
| Rate for Payer: Aetna Commercial |
$13.91
|
| Rate for Payer: Aetna Medicare |
$4.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.12
|
| Rate for Payer: BCBS Complete |
$3.03
|
| Rate for Payer: BCBS MAPPO |
$4.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.46
|
| Rate for Payer: BCN Commercial |
$13.46
|
| Rate for Payer: BCN Medicare Advantage |
$4.09
|
| Rate for Payer: Cash Price |
$13.10
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.09
|
| Rate for Payer: Healthscope Commercial |
$14.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.28
|
| Rate for Payer: Mclaren Medicaid |
$2.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.30
|
| Rate for Payer: Meridian Medicaid |
$3.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.91
|
| Rate for Payer: Nomi Health Commercial |
$13.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.28
|
| Rate for Payer: PACE Senior Care Partners |
$3.89
|
| Rate for Payer: PACE SWMI |
$4.09
|
| Rate for Payer: PHP Commercial |
$13.91
|
| Rate for Payer: PHP Medicare Advantage |
$4.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.24
|
| Rate for Payer: Priority Health Medicare |
$4.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.39
|
| Rate for Payer: Railroad Medicare Medicare |
$4.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.41
|
| Rate for Payer: UHC Core |
$13.67
|
| Rate for Payer: UHC Exchange |
$4.09
|
| Rate for Payer: UHC Medicaid |
$2.89
|
| Rate for Payer: UHC Medicare Advantage |
$4.09
|
| Rate for Payer: UHCCP Medicaid |
$2.89
|
| Rate for Payer: VA VA |
$4.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.28
|
|
|
HC HIAA SEROTONIN URINE
|
Facility
|
IP
|
$45.63
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: BCBS Trust/PPO |
$37.69
|
| Rate for Payer: BCN Commercial |
$37.69
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC HIAA SEROTONIN URINE
|
Facility
|
OP
|
$45.63
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: Aetna Medicare |
$11.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.26
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS MAPPO |
$11.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.51
|
| Rate for Payer: BCN Commercial |
$37.51
|
| Rate for Payer: BCN Medicare Advantage |
$11.41
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Mclaren Medicaid |
$8.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$8.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PACE Senior Care Partners |
$10.84
|
| Rate for Payer: PACE SWMI |
$11.41
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: PHP Medicare Advantage |
$11.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Medicare |
$11.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: UHC Exchange |
$11.41
|
| Rate for Payer: UHC Medicaid |
$8.04
|
| Rate for Payer: UHC Medicare Advantage |
$11.41
|
| Rate for Payer: UHCCP Medicaid |
$8.04
|
| Rate for Payer: VA VA |
$11.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
OP
|
$43.01
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$38.71 |
| Rate for Payer: Aetna Commercial |
$36.56
|
| Rate for Payer: Aetna Medicare |
$11.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.44
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: BCBS MAPPO |
$10.75
|
| Rate for Payer: BCBS Trust/PPO |
$35.36
|
| Rate for Payer: BCN Commercial |
$35.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.75
|
| Rate for Payer: Cash Price |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.75
|
| Rate for Payer: Healthscope Commercial |
$38.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.26
|
| Rate for Payer: Mclaren Medicaid |
$7.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.29
|
| Rate for Payer: Meridian Medicaid |
$7.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.56
|
| Rate for Payer: Nomi Health Commercial |
$35.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.26
|
| Rate for Payer: PACE Senior Care Partners |
$10.21
|
| Rate for Payer: PACE SWMI |
$10.75
|
| Rate for Payer: PHP Commercial |
$36.56
|
| Rate for Payer: PHP Medicare Advantage |
$10.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.42
|
| Rate for Payer: Priority Health Medicare |
$10.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.93
|
| Rate for Payer: Railroad Medicare Medicare |
$10.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.85
|
| Rate for Payer: UHC Core |
$35.91
|
| Rate for Payer: UHC Exchange |
$10.75
|
| Rate for Payer: UHC Medicaid |
$7.58
|
| Rate for Payer: UHC Medicare Advantage |
$10.75
|
| Rate for Payer: UHCCP Medicaid |
$7.58
|
| Rate for Payer: VA VA |
$10.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.26
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
IP
|
$43.01
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.93 |
| Max. Negotiated Rate |
$38.71 |
| Rate for Payer: Aetna Commercial |
$36.56
|
| Rate for Payer: BCBS Trust/PPO |
$35.52
|
| Rate for Payer: BCN Commercial |
$35.52
|
| Rate for Payer: Cash Price |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.41
|
| Rate for Payer: Healthscope Commercial |
$38.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.56
|
| Rate for Payer: Nomi Health Commercial |
$35.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.26
|
| Rate for Payer: PHP Commercial |
$36.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.85
|
| Rate for Payer: UHC Core |
$35.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.26
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
OP
|
$1,064.33
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$187.64 |
| Max. Negotiated Rate |
$957.90 |
| Rate for Payer: Aetna Commercial |
$904.68
|
| Rate for Payer: Aetna Medicare |
$276.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$332.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$332.60
|
| Rate for Payer: BCBS Complete |
$197.01
|
| Rate for Payer: BCBS MAPPO |
$266.08
|
| Rate for Payer: BCBS Trust/PPO |
$874.99
|
| Rate for Payer: BCN Commercial |
$874.99
|
| Rate for Payer: BCN Medicare Advantage |
$266.08
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$915.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.08
|
| Rate for Payer: Healthscope Commercial |
$957.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.25
|
| Rate for Payer: Mclaren Medicaid |
$187.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.39
|
| Rate for Payer: Meridian Medicaid |
$197.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$292.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: Nomi Health Commercial |
$872.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$798.25
|
| Rate for Payer: PACE Senior Care Partners |
$252.78
|
| Rate for Payer: PACE SWMI |
$266.08
|
| Rate for Payer: PHP Commercial |
$904.68
|
| Rate for Payer: PHP Medicare Advantage |
$266.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$925.97
|
| Rate for Payer: Priority Health Medicare |
$268.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$740.77
|
| Rate for Payer: Railroad Medicare Medicare |
$266.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.61
|
| Rate for Payer: UHC Core |
$888.72
|
| Rate for Payer: UHC Exchange |
$266.08
|
| Rate for Payer: UHC Medicaid |
$187.64
|
| Rate for Payer: UHC Medicare Advantage |
$266.08
|
| Rate for Payer: UHCCP Medicaid |
$187.64
|
| Rate for Payer: VA VA |
$266.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.25
|
|
