|
HC HUMAN PAPILLOMAVIRUS HIGH RISK
|
Facility
|
IP
|
$101.05
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
30600221
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.33 |
| Max. Negotiated Rate |
$90.94 |
| Rate for Payer: Aetna Commercial |
$85.89
|
| Rate for Payer: BCBS Trust/PPO |
$83.46
|
| Rate for Payer: BCN Commercial |
$83.46
|
| Rate for Payer: Cash Price |
$80.84
|
| Rate for Payer: Cofinity Commercial |
$86.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.84
|
| Rate for Payer: Healthscope Commercial |
$90.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.89
|
| Rate for Payer: Nomi Health Commercial |
$82.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.79
|
| Rate for Payer: PHP Commercial |
$85.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.92
|
| Rate for Payer: UHC Core |
$84.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.79
|
|
|
HC HUMAN PARECHOVIRUS
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600273
|
|
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 HUMAN PARECHOVIRUS
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600273
|
|
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 HYALUORAN OR DERIVATIVE, SYN OR SYN1, INTRA-ARTICULAR INJ, 1MG
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
63600107
|
|
Hospital Revenue Code
|
636
|
| 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 HYALUORAN OR DERIVATIVE, SYN OR SYN1, INTRA-ARTICULAR INJ, 1MG
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
63600107
|
|
Hospital Revenue Code
|
636
|
| 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 HYALURONAN FOR IA INJ PER DOSE
|
Facility
|
OP
|
$315.18
|
|
|
Service Code
|
HCPCS J7321
|
| Hospital Charge Code |
63600157
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.57 |
| Max. Negotiated Rate |
$283.66 |
| Rate for Payer: Aetna Commercial |
$267.90
|
| Rate for Payer: Aetna Medicare |
$81.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.49
|
| Rate for Payer: BCBS Complete |
$58.34
|
| Rate for Payer: BCBS MAPPO |
$78.80
|
| Rate for Payer: BCBS Trust/PPO |
$259.11
|
| Rate for Payer: BCN Commercial |
$259.11
|
| Rate for Payer: BCN Medicare Advantage |
$78.80
|
| Rate for Payer: Cash Price |
$252.14
|
| Rate for Payer: Cofinity Commercial |
$271.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.80
|
| Rate for Payer: Healthscope Commercial |
$283.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.38
|
| Rate for Payer: Mclaren Medicaid |
$55.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.73
|
| Rate for Payer: Meridian Medicaid |
$58.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.90
|
| Rate for Payer: Nomi Health Commercial |
$258.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.38
|
| Rate for Payer: PACE Senior Care Partners |
$74.86
|
| Rate for Payer: PACE SWMI |
$78.80
|
| Rate for Payer: PHP Commercial |
$267.90
|
| Rate for Payer: PHP Medicare Advantage |
$78.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.21
|
| Rate for Payer: Priority Health Medicare |
$79.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.37
|
| Rate for Payer: Railroad Medicare Medicare |
$78.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.36
|
| Rate for Payer: UHC Core |
$263.18
|
| Rate for Payer: UHC Exchange |
$78.80
|
| Rate for Payer: UHC Medicaid |
$55.57
|
| Rate for Payer: UHC Medicare Advantage |
$78.80
|
| Rate for Payer: UHCCP Medicaid |
$55.57
|
| Rate for Payer: VA VA |
$78.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.38
|
|
|
HC HYALURONAN FOR IA INJ PER DOSE
|
Facility
|
IP
|
$315.18
|
|
|
Service Code
|
HCPCS J7321
|
| Hospital Charge Code |
63600157
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$219.37 |
| Max. Negotiated Rate |
$283.66 |
| Rate for Payer: Aetna Commercial |
$267.90
|
| Rate for Payer: BCBS Trust/PPO |
$260.31
|
| Rate for Payer: BCN Commercial |
$260.31
|
| Rate for Payer: Cash Price |
$252.14
|
| Rate for Payer: Cofinity Commercial |
$271.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.14
|
| Rate for Payer: Healthscope Commercial |
$283.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.90
|
| Rate for Payer: Nomi Health Commercial |
$258.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.38
|
| Rate for Payer: PHP Commercial |
$267.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.36
|
| Rate for Payer: UHC Core |
$263.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.38
|
|
|
HC HYALURONAN OR DERIVATIVE, DURALONE, INTRAARTICULAR INJ, 1MG
|
Facility
|
OP
|
$21.93
|
|
|
Service Code
|
HCPCS J7318
|
| Hospital Charge Code |
63600163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$19.74 |
| Rate for Payer: Aetna Commercial |
$18.64
|
| Rate for Payer: Aetna Medicare |
$5.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.85
|
| Rate for Payer: BCBS Complete |
$4.06
|
| Rate for Payer: BCBS MAPPO |
$5.48
|
| Rate for Payer: BCBS Trust/PPO |
$18.03
|
| Rate for Payer: BCN Commercial |
$18.03
|
| Rate for Payer: BCN Medicare Advantage |
$5.48
|
| Rate for Payer: Cash Price |
$17.54
|
| Rate for Payer: Cofinity Commercial |
$18.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.48
|
| Rate for Payer: Healthscope Commercial |
$19.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.45
|
| Rate for Payer: Mclaren Medicaid |
$3.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.76
|
| Rate for Payer: Meridian Medicaid |
$4.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.64
|
| Rate for Payer: Nomi Health Commercial |
$17.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.45
|
| Rate for Payer: PACE Senior Care Partners |
$5.21
|
| Rate for Payer: PACE SWMI |
$5.48
|
| Rate for Payer: PHP Commercial |
$18.64
|
| Rate for Payer: PHP Medicare Advantage |
$5.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.08
|
| Rate for Payer: Priority Health Medicare |
$5.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.30
|
| Rate for Payer: UHC Core |
$18.31
|
| Rate for Payer: UHC Exchange |
$5.48
|
| Rate for Payer: UHC Medicaid |
$3.87
|
| Rate for Payer: UHC Medicare Advantage |
$5.48
|
| Rate for Payer: UHCCP Medicaid |
$3.87
|
| Rate for Payer: VA VA |
$5.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.45
|
|
|
HC HYALURONAN OR DERIVATIVE, DURALONE, INTRAARTICULAR INJ, 1MG
|
Facility
|
IP
|
$21.93
|
|
|
Service Code
|
HCPCS J7318
|
| Hospital Charge Code |
63600163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.26 |
| Max. Negotiated Rate |
$19.74 |
| Rate for Payer: Aetna Commercial |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$18.11
|
| Rate for Payer: BCN Commercial |
$18.11
|
| Rate for Payer: Cash Price |
$17.54
|
| Rate for Payer: Cofinity Commercial |
$18.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.54
|
| Rate for Payer: Healthscope Commercial |
$19.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.64
|
| Rate for Payer: Nomi Health Commercial |
$17.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.45
|
| Rate for Payer: PHP Commercial |
$18.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.30
|
| Rate for Payer: UHC Core |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.45
|
|
|
HC HYALURONAN OR DERIVATIVE, GEL 1, INTRA-ARTICULAR INJ PER DOSE
|
Facility
|
OP
|
$1,422.02
|
|
|
Service Code
|
CPT J7326
|
| Hospital Charge Code |
63600108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$1,279.82 |
| Rate for Payer: Aetna Commercial |
$1,208.72
|
| Rate for Payer: Aetna Medicare |
$369.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$444.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$444.38
|
| Rate for Payer: BCBS Complete |
$263.22
|
| Rate for Payer: BCBS MAPPO |
$355.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,169.04
|
| Rate for Payer: BCN Commercial |
$1,169.04
|
| Rate for Payer: BCN Medicare Advantage |
$355.50
|
| Rate for Payer: Cash Price |
$1,137.62
|
| Rate for Payer: Cofinity Commercial |
$1,222.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,137.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.50
|
| Rate for Payer: Healthscope Commercial |
$1,279.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,066.52
|
| Rate for Payer: Mclaren Medicaid |
$250.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.28
|
| Rate for Payer: Meridian Medicaid |
$263.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$391.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,208.72
|
| Rate for Payer: Nomi Health Commercial |
$1,166.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,066.52
|
| Rate for Payer: PACE Senior Care Partners |
$337.73
|
| Rate for Payer: PACE SWMI |
$355.50
|
| Rate for Payer: PHP Commercial |
$1,208.72
|
| Rate for Payer: PHP Medicare Advantage |
$355.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,237.16
|
| Rate for Payer: Priority Health Medicare |
$359.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$989.73
|
| Rate for Payer: Railroad Medicare Medicare |
$355.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,251.38
|
| Rate for Payer: UHC Core |
$1,187.39
|
| Rate for Payer: UHC Exchange |
$355.50
|
| Rate for Payer: UHC Medicaid |
$250.70
|
| Rate for Payer: UHC Medicare Advantage |
$355.50
|
| Rate for Payer: UHCCP Medicaid |
$250.70
|
| Rate for Payer: VA VA |
$355.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,066.52
|
|
|
HC HYALURONAN OR DERIVATIVE, GEL 1, INTRA-ARTICULAR INJ PER DOSE
|
Facility
|
IP
|
$1,422.02
|
|
|
Service Code
|
CPT J7326
|
| Hospital Charge Code |
63600108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$989.73 |
| Max. Negotiated Rate |
$1,279.82 |
| Rate for Payer: Aetna Commercial |
$1,208.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.45
|
| Rate for Payer: BCN Commercial |
$1,174.45
|
| Rate for Payer: Cash Price |
$1,137.62
|
| Rate for Payer: Cofinity Commercial |
$1,222.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,137.62
|
| Rate for Payer: Healthscope Commercial |
$1,279.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,066.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,208.72
|
| Rate for Payer: Nomi Health Commercial |
$1,166.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,066.52
|
| Rate for Payer: PHP Commercial |
$1,208.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,237.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$989.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,251.38
|
| Rate for Payer: UHC Core |
$1,187.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,066.52
|
|
|
HC HYDROCODONE AND MTB, FREE
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100685
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.98 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$26.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.86
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: BCBS MAPPO |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$83.82
|
| Rate for Payer: BCN Commercial |
$83.82
|
| Rate for Payer: BCN Medicare Advantage |
$25.49
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.49
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.76
|
| Rate for Payer: Meridian Medicaid |
$18.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.49
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Medicare |
$25.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: UHC Exchange |
$25.49
|
| Rate for Payer: UHC Medicaid |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: UHCCP Medicaid |
$17.98
|
| Rate for Payer: VA VA |
$25.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC HYDROCODONE AND MTB, FREE
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100685
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.96 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: BCBS Trust/PPO |
$84.21
|
| Rate for Payer: BCN Commercial |
$84.21
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC HYDROCORTIZONE CREAM
|
Facility
|
IP
|
$10.12
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$9.11 |
| Rate for Payer: Aetna Commercial |
$8.60
|
| Rate for Payer: BCBS Trust/PPO |
$8.36
|
| Rate for Payer: BCN Commercial |
$8.36
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cofinity Commercial |
$8.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.10
|
| Rate for Payer: Healthscope Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.60
|
| Rate for Payer: Nomi Health Commercial |
$8.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.59
|
| Rate for Payer: PHP Commercial |
$8.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.91
|
| Rate for Payer: UHC Core |
$8.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.59
|
|
|
HC HYDROCORTIZONE CREAM
|
Facility
|
OP
|
$10.12
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$9.11 |
| Rate for Payer: Aetna Commercial |
$8.60
|
| Rate for Payer: Aetna Medicare |
$2.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.16
|
| Rate for Payer: BCBS Complete |
$1.87
|
| Rate for Payer: BCBS MAPPO |
$2.53
|
| Rate for Payer: BCBS Trust/PPO |
$8.32
|
| Rate for Payer: BCN Commercial |
$8.32
|
| Rate for Payer: BCN Medicare Advantage |
$2.53
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cofinity Commercial |
$8.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.53
|
| Rate for Payer: Healthscope Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.59
|
| Rate for Payer: Mclaren Medicaid |
$1.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.66
|
| Rate for Payer: Meridian Medicaid |
$1.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.60
|
| Rate for Payer: Nomi Health Commercial |
$8.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.59
|
| Rate for Payer: PACE Senior Care Partners |
$2.40
|
| Rate for Payer: PACE SWMI |
$2.53
|
| Rate for Payer: PHP Commercial |
$8.60
|
| Rate for Payer: PHP Medicare Advantage |
$2.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.80
|
| Rate for Payer: Priority Health Medicare |
$2.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.04
|
| Rate for Payer: Railroad Medicare Medicare |
$2.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.91
|
| Rate for Payer: UHC Core |
$8.45
|
| Rate for Payer: UHC Exchange |
$2.53
|
| Rate for Payer: UHC Medicaid |
$1.78
|
| Rate for Payer: UHC Medicare Advantage |
$2.53
|
| Rate for Payer: UHCCP Medicaid |
$1.78
|
| Rate for Payer: VA VA |
$2.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.59
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
IP
|
$686.66
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$477.92 |
| Max. Negotiated Rate |
$617.99 |
| Rate for Payer: Aetna Commercial |
$583.66
|
| Rate for Payer: BCBS Trust/PPO |
$567.11
|
| Rate for Payer: BCN Commercial |
$567.11
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Commercial |
$590.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Healthscope Commercial |
$617.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Nomi Health Commercial |
$563.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: PHP Commercial |
$583.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$597.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.26
|
| Rate for Payer: UHC Core |
$573.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.00
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
OP
|
$686.66
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.06 |
| Max. Negotiated Rate |
$617.99 |
| Rate for Payer: Aetna Commercial |
$583.66
|
| Rate for Payer: Aetna Medicare |
$178.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.58
|
| Rate for Payer: BCBS Complete |
$127.10
|
| Rate for Payer: BCBS MAPPO |
$171.66
|
| Rate for Payer: BCBS Trust/PPO |
$564.50
|
| Rate for Payer: BCN Commercial |
$564.50
|
| Rate for Payer: BCN Medicare Advantage |
$171.66
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Commercial |
$590.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.66
|
| Rate for Payer: Healthscope Commercial |
$617.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.00
|
| Rate for Payer: Mclaren Medicaid |
$121.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.25
|
| Rate for Payer: Meridian Medicaid |
$127.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Nomi Health Commercial |
$563.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: PACE Senior Care Partners |
$163.08
|
| Rate for Payer: PACE SWMI |
$171.66
|
| Rate for Payer: PHP Commercial |
$583.66
|
| Rate for Payer: PHP Medicare Advantage |
$171.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$597.39
|
| Rate for Payer: Priority Health Medicare |
$173.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.92
|
| Rate for Payer: Railroad Medicare Medicare |
$171.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.26
|
| Rate for Payer: UHC Core |
$573.36
|
| Rate for Payer: UHC Exchange |
$171.66
|
| Rate for Payer: UHC Medicaid |
$121.06
|
| Rate for Payer: UHC Medicare Advantage |
$171.66
|
| Rate for Payer: UHCCP Medicaid |
$121.06
|
| Rate for Payer: VA VA |
$171.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.00
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
OP
|
$90.51
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.96 |
| Max. Negotiated Rate |
$81.46 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna Medicare |
$23.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.28
|
| Rate for Payer: BCBS Complete |
$16.75
|
| Rate for Payer: BCBS MAPPO |
$22.63
|
| Rate for Payer: BCBS Trust/PPO |
$74.41
|
| Rate for Payer: BCN Commercial |
$74.41
|
| Rate for Payer: BCN Medicare Advantage |
$22.63
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.63
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Mclaren Medicaid |
$15.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.76
|
| Rate for Payer: Meridian Medicaid |
$16.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.88
|
| Rate for Payer: PACE Senior Care Partners |
$21.50
|
| Rate for Payer: PACE SWMI |
$22.63
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: PHP Medicare Advantage |
$22.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.74
|
| Rate for Payer: Priority Health Medicare |
$22.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.65
|
| Rate for Payer: UHC Core |
$75.58
|
| Rate for Payer: UHC Exchange |
$22.63
|
| Rate for Payer: UHC Medicaid |
$15.96
|
| Rate for Payer: UHC Medicare Advantage |
$22.63
|
| Rate for Payer: UHCCP Medicaid |
$15.96
|
| Rate for Payer: VA VA |
$22.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
IP
|
$90.51
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.99 |
| Max. Negotiated Rate |
$81.46 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: BCBS Trust/PPO |
$74.75
|
| Rate for Payer: BCN Commercial |
$74.75
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.88
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.65
|
| Rate for Payer: UHC Core |
$75.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
OP
|
$48.64
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.58 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$12.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.20
|
| Rate for Payer: BCBS Complete |
$9.00
|
| Rate for Payer: BCBS MAPPO |
$12.16
|
| Rate for Payer: BCBS Trust/PPO |
$39.99
|
| Rate for Payer: BCN Commercial |
$39.99
|
| Rate for Payer: BCN Medicare Advantage |
$12.16
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.16
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Mclaren Medicaid |
$8.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.77
|
| Rate for Payer: Meridian Medicaid |
$9.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Nomi Health Commercial |
$39.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.55
|
| Rate for Payer: PACE SWMI |
$12.16
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: PHP Medicare Advantage |
$12.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.32
|
| Rate for Payer: Priority Health Medicare |
$12.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.85
|
| Rate for Payer: Railroad Medicare Medicare |
$12.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.80
|
| Rate for Payer: UHC Core |
$40.61
|
| Rate for Payer: UHC Exchange |
$12.16
|
| Rate for Payer: UHC Medicaid |
$8.58
|
| Rate for Payer: UHC Medicare Advantage |
$12.16
|
| Rate for Payer: UHCCP Medicaid |
$8.58
|
| Rate for Payer: VA VA |
$12.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
IP
|
$48.64
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.85 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: BCBS Trust/PPO |
$40.17
|
| Rate for Payer: BCN Commercial |
$40.17
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Nomi Health Commercial |
$39.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.48
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.80
|
| Rate for Payer: UHC Core |
$40.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
IP
|
$28.65
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.94 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna Commercial |
$24.35
|
| Rate for Payer: BCBS Trust/PPO |
$23.66
|
| Rate for Payer: BCN Commercial |
$23.66
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$24.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$23.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PHP Commercial |
$24.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.21
|
| Rate for Payer: UHC Core |
$23.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.49
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
OP
|
$28.65
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.05 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna Commercial |
$24.35
|
| Rate for Payer: Aetna Medicare |
$7.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.95
|
| Rate for Payer: BCBS Complete |
$5.30
|
| Rate for Payer: BCBS MAPPO |
$7.16
|
| Rate for Payer: BCBS Trust/PPO |
$23.55
|
| Rate for Payer: BCN Commercial |
$23.55
|
| Rate for Payer: BCN Medicare Advantage |
$7.16
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$24.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.49
|
| Rate for Payer: Mclaren Medicaid |
$5.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.52
|
| Rate for Payer: Meridian Medicaid |
$5.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$23.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PACE Senior Care Partners |
$6.80
|
| Rate for Payer: PACE SWMI |
$7.16
|
| Rate for Payer: PHP Commercial |
$24.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.93
|
| Rate for Payer: Priority Health Medicare |
$7.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.94
|
| Rate for Payer: Railroad Medicare Medicare |
$7.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.21
|
| Rate for Payer: UHC Core |
$23.92
|
| Rate for Payer: UHC Exchange |
$7.16
|
| Rate for Payer: UHC Medicaid |
$5.05
|
| Rate for Payer: UHC Medicare Advantage |
$7.16
|
| Rate for Payer: UHCCP Medicaid |
$5.05
|
| Rate for Payer: VA VA |
$7.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.49
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.50
|
| Rate for Payer: BCBS MAPPO |
$7.43
|
| Rate for Payer: BCBS Trust/PPO |
$24.42
|
| Rate for Payer: BCN Commercial |
$24.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.43
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.43
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Mclaren Medicaid |
$5.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.80
|
| Rate for Payer: Meridian Medicaid |
$5.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Senior Care Partners |
$7.06
|
| Rate for Payer: PACE SWMI |
$7.43
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$7.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: Railroad Medicare Medicare |
$7.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: UHC Exchange |
$7.43
|
| Rate for Payer: UHC Medicaid |
$5.24
|
| Rate for Payer: UHC Medicare Advantage |
$7.43
|
| Rate for Payer: UHCCP Medicaid |
$5.24
|
| Rate for Payer: VA VA |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.68 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
