|
HC MUCORE RACEMOSUS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MUGWORT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MUGWORT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MULBERRY IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MULBERRY IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
OP
|
$6.55
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna Commercial |
$5.57
|
| Rate for Payer: Aetna Medicare |
$1.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.05
|
| Rate for Payer: BCBS Complete |
$2.62
|
| Rate for Payer: BCBS MAPPO |
$1.64
|
| Rate for Payer: BCBS Trust/PPO |
$5.09
|
| Rate for Payer: BCN Commercial |
$5.09
|
| Rate for Payer: BCN Medicare Advantage |
$1.64
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cofinity Commercial |
$5.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.64
|
| Rate for Payer: Healthscope Commercial |
$5.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.57
|
| Rate for Payer: PACE Senior Care Partners |
$1.56
|
| Rate for Payer: PACE SWMI |
$1.64
|
| Rate for Payer: PHP Commercial |
$5.57
|
| Rate for Payer: PHP Medicare Advantage |
$1.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.70
|
| Rate for Payer: Priority Health Medicare |
$1.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.76
|
| Rate for Payer: UHC Core |
$5.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.64
|
| Rate for Payer: UHC Medicare Advantage |
$1.69
|
| Rate for Payer: VA VA |
$1.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.91
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$6.55
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna Commercial |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$5.06
|
| Rate for Payer: BCN Commercial |
$5.06
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cofinity Commercial |
$5.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.24
|
| Rate for Payer: Healthscope Commercial |
$5.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.57
|
| Rate for Payer: PHP Commercial |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.76
|
| Rate for Payer: UHC Core |
$5.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.91
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$629.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$383.63 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna Commercial |
$534.65
|
| Rate for Payer: BCBS Trust/PPO |
$486.09
|
| Rate for Payer: BCN Commercial |
$486.09
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$540.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.20
|
| Rate for Payer: Healthscope Commercial |
$566.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$534.65
|
| Rate for Payer: PHP Commercial |
$534.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$383.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.52
|
| Rate for Payer: UHC Core |
$525.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.75
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$629.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna Commercial |
$534.65
|
| Rate for Payer: Aetna Medicare |
$163.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.56
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$157.25
|
| Rate for Payer: BCBS Trust/PPO |
$489.05
|
| Rate for Payer: BCN Commercial |
$489.05
|
| Rate for Payer: BCN Medicare Advantage |
$157.25
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$540.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.25
|
| Rate for Payer: Healthscope Commercial |
$566.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.75
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$534.65
|
| Rate for Payer: PACE Senior Care Partners |
$149.39
|
| Rate for Payer: PACE SWMI |
$157.25
|
| Rate for Payer: PHP Commercial |
$534.65
|
| Rate for Payer: PHP Medicare Advantage |
$157.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.23
|
| Rate for Payer: Priority Health Medicare |
$157.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$383.63
|
| Rate for Payer: Railroad Medicare Medicare |
$157.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.52
|
| Rate for Payer: UHC Core |
$525.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.25
|
| Rate for Payer: UHC Medicare Advantage |
$161.97
|
| Rate for Payer: VA VA |
$157.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.75
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
OP
|
$836.40
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$198.64 |
| Max. Negotiated Rate |
$752.76 |
| Rate for Payer: Aetna Commercial |
$710.94
|
| Rate for Payer: Aetna Commercial |
$1,048.90
|
| Rate for Payer: Aetna Medicare |
$217.46
|
| Rate for Payer: Aetna Medicare |
$320.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$261.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$261.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.62
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS MAPPO |
$209.10
|
| Rate for Payer: BCBS MAPPO |
$308.50
|
| Rate for Payer: BCBS Trust/PPO |
$650.30
|
| Rate for Payer: BCBS Trust/PPO |
$959.44
|
| Rate for Payer: BCN Commercial |
$959.44
|
| Rate for Payer: BCN Commercial |
$650.30
|
| Rate for Payer: BCN Medicare Advantage |
$209.10
|
| Rate for Payer: BCN Medicare Advantage |
$308.50
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cofinity Commercial |
$719.30
|
| Rate for Payer: Cofinity Commercial |
$1,061.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.10
|
| Rate for Payer: Healthscope Commercial |
$752.76
|
| Rate for Payer: Healthscope Commercial |
$1,110.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.50
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$323.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$219.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$710.94
|
| Rate for Payer: PACE Senior Care Partners |
$198.64
|
| Rate for Payer: PACE Senior Care Partners |
$293.08
|
| Rate for Payer: PACE SWMI |
$308.50
|
| Rate for Payer: PACE SWMI |
$209.10
|
| Rate for Payer: PHP Commercial |
$710.94
|
| Rate for Payer: PHP Commercial |
$1,048.90
|
| Rate for Payer: PHP Medicare Advantage |
$308.50
|
| Rate for Payer: PHP Medicare Advantage |
$209.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.58
|
| Rate for Payer: Priority Health Medicare |
$209.10
|
| Rate for Payer: Priority Health Medicare |
$308.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$510.12
|
| Rate for Payer: Railroad Medicare Medicare |
$308.50
|
| Rate for Payer: Railroad Medicare Medicare |
$209.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$736.03
|
| Rate for Payer: UHC Core |
$1,030.39
|
| Rate for Payer: UHC Core |
$698.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.10
|
| Rate for Payer: UHC Medicare Advantage |
$317.76
|
| Rate for Payer: UHC Medicare Advantage |
$215.37
|
| Rate for Payer: VA VA |
$209.10
|
| Rate for Payer: VA VA |
$308.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.30
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
IP
|
$1,234.00
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$752.62 |
| Max. Negotiated Rate |
$1,110.60 |
| Rate for Payer: Aetna Commercial |
$1,048.90
|
| Rate for Payer: Aetna Commercial |
$710.94
|
| Rate for Payer: BCBS Trust/PPO |
$953.64
|
| Rate for Payer: BCBS Trust/PPO |
$646.37
|
| Rate for Payer: BCN Commercial |
$646.37
|
| Rate for Payer: BCN Commercial |
$953.64
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$1,061.24
|
| Rate for Payer: Cofinity Commercial |
$719.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.12
|
| Rate for Payer: Healthscope Commercial |
$752.76
|
| Rate for Payer: Healthscope Commercial |
$1,110.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$710.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: PHP Commercial |
$710.94
|
| Rate for Payer: PHP Commercial |
$1,048.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$510.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$736.03
|
| Rate for Payer: UHC Core |
$698.39
|
| Rate for Payer: UHC Core |
$1,030.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.30
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
IP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.24 |
| Max. Negotiated Rate |
$108.07 |
| Rate for Payer: Aetna Commercial |
$102.07
|
| Rate for Payer: BCBS Trust/PPO |
$92.80
|
| Rate for Payer: BCN Commercial |
$92.80
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$103.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Healthscope Commercial |
$108.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.07
|
| Rate for Payer: PHP Commercial |
$102.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.67
|
| Rate for Payer: UHC Core |
$100.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.06
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
OP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$108.07 |
| Rate for Payer: Aetna Commercial |
$102.07
|
| Rate for Payer: Aetna Medicare |
$31.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.52
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$30.02
|
| Rate for Payer: BCBS Trust/PPO |
$93.36
|
| Rate for Payer: BCN Commercial |
$93.36
|
| Rate for Payer: BCN Medicare Advantage |
$30.02
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$103.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.02
|
| Rate for Payer: Healthscope Commercial |
$108.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.06
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.07
|
| Rate for Payer: PACE Senior Care Partners |
$28.52
|
| Rate for Payer: PACE SWMI |
$30.02
|
| Rate for Payer: PHP Commercial |
$102.07
|
| Rate for Payer: PHP Medicare Advantage |
$30.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.47
|
| Rate for Payer: Priority Health Medicare |
$30.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.24
|
| Rate for Payer: Railroad Medicare Medicare |
$30.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.67
|
| Rate for Payer: UHC Core |
$100.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.02
|
| Rate for Payer: UHC Medicare Advantage |
$30.92
|
| Rate for Payer: VA VA |
$30.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.06
|
|
|
HC MUMPS AB IGG
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.63 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$20.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.69
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$19.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.42
|
| Rate for Payer: BCN Commercial |
$61.42
|
| Rate for Payer: BCN Medicare Advantage |
$19.75
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.75
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Mclaren Medicaid |
$9.63
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Senior Care Partners |
$18.76
|
| Rate for Payer: PACE SWMI |
$19.75
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$19.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Medicare |
$19.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$20.34
|
| Rate for Payer: VA VA |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC MUMPS AB IGG
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.18 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.05
|
| Rate for Payer: BCN Commercial |
$61.05
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.63 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna Commercial |
$64.60
|
| Rate for Payer: Aetna Medicare |
$19.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.75
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$19.00
|
| Rate for Payer: BCBS Trust/PPO |
$59.09
|
| Rate for Payer: BCN Commercial |
$59.09
|
| Rate for Payer: BCN Medicare Advantage |
$19.00
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$65.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.00
|
| Rate for Payer: Healthscope Commercial |
$68.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.00
|
| Rate for Payer: Mclaren Medicaid |
$9.63
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.60
|
| Rate for Payer: PACE Senior Care Partners |
$18.05
|
| Rate for Payer: PACE SWMI |
$19.00
|
| Rate for Payer: PHP Commercial |
$64.60
|
| Rate for Payer: PHP Medicare Advantage |
$19.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.12
|
| Rate for Payer: Priority Health Medicare |
$19.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.35
|
| Rate for Payer: Railroad Medicare Medicare |
$19.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.88
|
| Rate for Payer: UHC Core |
$63.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.00
|
| Rate for Payer: UHC Medicare Advantage |
$19.57
|
| Rate for Payer: VA VA |
$19.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.00
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.35 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna Commercial |
$64.60
|
| Rate for Payer: BCBS Trust/PPO |
$58.73
|
| Rate for Payer: BCN Commercial |
$58.73
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$65.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.80
|
| Rate for Payer: Healthscope Commercial |
$68.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.60
|
| Rate for Payer: PHP Commercial |
$64.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.88
|
| Rate for Payer: UHC Core |
$63.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.00
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$13.32
|
| Rate for Payer: Meridian Medicaid |
$13.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$5.36
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$5.36
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.36
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Senior Care Partners |
$5.09
|
| Rate for Payer: PACE SWMI |
$5.36
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.36
|
| Rate for Payer: UHC Medicare Advantage |
$5.52
|
| Rate for Payer: VA VA |
$5.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$16.55
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
IP
|
$20.33
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$18.30 |
| Rate for Payer: Aetna Commercial |
$17.28
|
| Rate for Payer: BCBS Trust/PPO |
$15.71
|
| Rate for Payer: BCN Commercial |
$15.71
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$17.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$18.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.28
|
| Rate for Payer: PHP Commercial |
$17.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.89
|
| Rate for Payer: UHC Core |
$16.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.25
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
OP
|
$20.33
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.83 |
| Max. Negotiated Rate |
$18.30 |
| Rate for Payer: Aetna Commercial |
$17.28
|
| Rate for Payer: Aetna Medicare |
$5.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.35
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$5.08
|
| Rate for Payer: BCBS Trust/PPO |
$15.81
|
| Rate for Payer: BCN Commercial |
$15.81
|
| Rate for Payer: BCN Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$17.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.08
|
| Rate for Payer: Healthscope Commercial |
$18.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.25
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.28
|
| Rate for Payer: PACE Senior Care Partners |
$4.83
|
| Rate for Payer: PACE SWMI |
$5.08
|
| Rate for Payer: PHP Commercial |
$17.28
|
| Rate for Payer: PHP Medicare Advantage |
$5.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.69
|
| Rate for Payer: Priority Health Medicare |
$5.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.89
|
| Rate for Payer: UHC Core |
$16.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.08
|
| Rate for Payer: UHC Medicare Advantage |
$5.23
|
| Rate for Payer: VA VA |
$5.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.25
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.63 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: BCBS Trust/PPO |
$83.15
|
| Rate for Payer: BCN Commercial |
$83.15
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.69
|
| Rate for Payer: UHC Core |
$89.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
