|
HC IMMUNIZATION EACH ADDL VACCINE
|
Facility
|
OP
|
$34.12
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
77100004
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$30.71 |
| Rate for Payer: Aetna Commercial |
$29.00
|
| Rate for Payer: Aetna Medicare |
$8.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.66
|
| Rate for Payer: BCBS Complete |
$6.32
|
| Rate for Payer: BCBS MAPPO |
$8.53
|
| Rate for Payer: BCBS Trust/PPO |
$28.05
|
| Rate for Payer: BCN Commercial |
$28.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.53
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.53
|
| Rate for Payer: Healthscope Commercial |
$30.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.59
|
| Rate for Payer: Mclaren Medicaid |
$6.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.96
|
| Rate for Payer: Meridian Medicaid |
$6.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$8.10
|
| Rate for Payer: PACE SWMI |
$8.53
|
| Rate for Payer: PHP Commercial |
$29.00
|
| Rate for Payer: PHP Medicare Advantage |
$8.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.68
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.75
|
| Rate for Payer: Railroad Medicare Medicare |
$8.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.03
|
| Rate for Payer: UHC Core |
$28.49
|
| Rate for Payer: UHC Exchange |
$8.53
|
| Rate for Payer: UHC Medicaid |
$6.02
|
| Rate for Payer: UHC Medicare Advantage |
$8.53
|
| Rate for Payer: UHCCP Medicaid |
$6.02
|
| Rate for Payer: VA VA |
$8.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.59
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE
|
Facility
|
IP
|
$34.12
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
77100004
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$23.75 |
| Max. Negotiated Rate |
$30.71 |
| Rate for Payer: Aetna Commercial |
$29.00
|
| Rate for Payer: BCBS Trust/PPO |
$28.18
|
| Rate for Payer: BCN Commercial |
$28.18
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$30.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.59
|
| Rate for Payer: PHP Commercial |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.03
|
| Rate for Payer: UHC Core |
$28.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.59
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$21.06
|
| Rate for Payer: BCN Commercial |
$21.06
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.12
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$4.72
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$20.96
|
| Rate for Payer: BCN Commercial |
$20.96
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$4.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.75
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Exchange |
$6.38
|
| Rate for Payer: UHC Medicaid |
$4.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$4.50
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
IP
|
$45.05
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$31.35 |
| Max. Negotiated Rate |
$40.55 |
| Rate for Payer: Aetna Commercial |
$38.29
|
| Rate for Payer: BCBS Trust/PPO |
$37.21
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: Cash Price |
$36.04
|
| Rate for Payer: Cofinity Commercial |
$38.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.04
|
| Rate for Payer: Healthscope Commercial |
$40.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.29
|
| Rate for Payer: Nomi Health Commercial |
$36.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.79
|
| Rate for Payer: PHP Commercial |
$38.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.64
|
| Rate for Payer: UHC Core |
$37.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.79
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
OP
|
$45.05
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$40.55 |
| Rate for Payer: Aetna Commercial |
$38.29
|
| Rate for Payer: Aetna Medicare |
$11.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.08
|
| Rate for Payer: BCBS Complete |
$8.34
|
| Rate for Payer: BCBS MAPPO |
$11.26
|
| Rate for Payer: BCBS Trust/PPO |
$37.04
|
| Rate for Payer: BCN Commercial |
$37.04
|
| Rate for Payer: BCN Medicare Advantage |
$11.26
|
| Rate for Payer: Cash Price |
$36.04
|
| Rate for Payer: Cofinity Commercial |
$38.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$40.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.79
|
| Rate for Payer: Mclaren Medicaid |
$7.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.83
|
| Rate for Payer: Meridian Medicaid |
$8.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.29
|
| Rate for Payer: Nomi Health Commercial |
$36.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.79
|
| Rate for Payer: PACE Senior Care Partners |
$10.70
|
| Rate for Payer: PACE SWMI |
$11.26
|
| Rate for Payer: PHP Commercial |
$38.29
|
| Rate for Payer: PHP Medicare Advantage |
$11.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.19
|
| Rate for Payer: Priority Health Medicare |
$11.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.35
|
| Rate for Payer: Railroad Medicare Medicare |
$11.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.64
|
| Rate for Payer: UHC Core |
$37.62
|
| Rate for Payer: UHC Exchange |
$11.26
|
| Rate for Payer: UHC Medicaid |
$7.94
|
| Rate for Payer: UHC Medicare Advantage |
$11.26
|
| Rate for Payer: UHCCP Medicaid |
$7.94
|
| Rate for Payer: VA VA |
$11.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.79
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
IP
|
$33.05
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$29.75 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.30
|
| Rate for Payer: BCN Commercial |
$27.30
|
| Rate for Payer: Cash Price |
$26.44
|
| Rate for Payer: Cofinity Commercial |
$28.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.44
|
| Rate for Payer: Healthscope Commercial |
$29.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.09
|
| Rate for Payer: Nomi Health Commercial |
$27.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.79
|
| Rate for Payer: PHP Commercial |
$28.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.08
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.79
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
OP
|
$33.05
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$29.75 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.33
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: BCN Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$26.44
|
| Rate for Payer: Cofinity Commercial |
$28.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.26
|
| Rate for Payer: Healthscope Commercial |
$29.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.79
|
| Rate for Payer: Mclaren Medicaid |
$5.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.68
|
| Rate for Payer: Meridian Medicaid |
$6.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.09
|
| Rate for Payer: Nomi Health Commercial |
$27.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.79
|
| Rate for Payer: PACE Senior Care Partners |
$7.85
|
| Rate for Payer: PACE SWMI |
$8.26
|
| Rate for Payer: PHP Commercial |
$28.09
|
| Rate for Payer: PHP Medicare Advantage |
$8.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.75
|
| Rate for Payer: Priority Health Medicare |
$8.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.00
|
| Rate for Payer: Railroad Medicare Medicare |
$8.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.08
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Exchange |
$8.26
|
| Rate for Payer: UHC Medicaid |
$5.83
|
| Rate for Payer: UHC Medicare Advantage |
$8.26
|
| Rate for Payer: UHCCP Medicaid |
$5.83
|
| Rate for Payer: VA VA |
$8.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.79
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
IP
|
$25.47
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.73 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$21.04
|
| Rate for Payer: BCN Commercial |
$21.04
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.10
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
OP
|
$25.47
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Medicare |
$6.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.96
|
| Rate for Payer: BCBS Complete |
$4.71
|
| Rate for Payer: BCBS MAPPO |
$6.37
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCN Commercial |
$20.94
|
| Rate for Payer: BCN Medicare Advantage |
$6.37
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.37
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Mclaren Medicaid |
$4.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$4.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.10
|
| Rate for Payer: PACE Senior Care Partners |
$6.05
|
| Rate for Payer: PACE SWMI |
$6.37
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Medicare Advantage |
$6.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health Medicare |
$6.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.73
|
| Rate for Payer: Railroad Medicare Medicare |
$6.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Exchange |
$6.37
|
| Rate for Payer: UHC Medicaid |
$4.49
|
| Rate for Payer: UHC Medicare Advantage |
$6.37
|
| Rate for Payer: UHCCP Medicaid |
$4.49
|
| Rate for Payer: VA VA |
$6.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
IP
|
$39.80
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.70 |
| Max. Negotiated Rate |
$35.82 |
| Rate for Payer: Aetna Commercial |
$33.83
|
| Rate for Payer: BCBS Trust/PPO |
$32.87
|
| Rate for Payer: BCN Commercial |
$32.87
|
| Rate for Payer: Cash Price |
$31.84
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.84
|
| Rate for Payer: Healthscope Commercial |
$35.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.83
|
| Rate for Payer: Nomi Health Commercial |
$32.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.85
|
| Rate for Payer: PHP Commercial |
$33.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.02
|
| Rate for Payer: UHC Core |
$33.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.85
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
OP
|
$39.80
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$35.82 |
| Rate for Payer: Aetna Commercial |
$33.83
|
| Rate for Payer: Aetna Medicare |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.44
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$9.95
|
| Rate for Payer: BCBS Trust/PPO |
$32.72
|
| Rate for Payer: BCN Commercial |
$32.72
|
| Rate for Payer: BCN Medicare Advantage |
$9.95
|
| Rate for Payer: Cash Price |
$31.84
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.95
|
| Rate for Payer: Healthscope Commercial |
$35.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.85
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.45
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.83
|
| Rate for Payer: Nomi Health Commercial |
$32.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.85
|
| Rate for Payer: PACE Senior Care Partners |
$9.45
|
| Rate for Payer: PACE SWMI |
$9.95
|
| Rate for Payer: PHP Commercial |
$33.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.63
|
| Rate for Payer: Priority Health Medicare |
$10.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.70
|
| Rate for Payer: Railroad Medicare Medicare |
$9.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.02
|
| Rate for Payer: UHC Core |
$33.23
|
| Rate for Payer: UHC Exchange |
$9.95
|
| Rate for Payer: UHC Medicaid |
$7.02
|
| Rate for Payer: UHC Medicare Advantage |
$9.95
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: VA VA |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.85
|
|
|
HC IMMUNOASSAY MULTI STEP FIRST
|
Facility
|
IP
|
$39.80
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100657
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.70 |
| Max. Negotiated Rate |
$35.82 |
| Rate for Payer: Aetna Commercial |
$33.83
|
| Rate for Payer: BCBS Trust/PPO |
$32.87
|
| Rate for Payer: BCN Commercial |
$32.87
|
| Rate for Payer: Cash Price |
$31.84
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.84
|
| Rate for Payer: Healthscope Commercial |
$35.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.83
|
| Rate for Payer: Nomi Health Commercial |
$32.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.85
|
| Rate for Payer: PHP Commercial |
$33.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.02
|
| Rate for Payer: UHC Core |
$33.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.85
|
|
|
HC IMMUNOASSAY MULTI STEP FIRST
|
Facility
|
OP
|
$39.80
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100657
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$35.82 |
| Rate for Payer: Aetna Commercial |
$33.83
|
| Rate for Payer: Aetna Medicare |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.44
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$9.95
|
| Rate for Payer: BCBS Trust/PPO |
$32.72
|
| Rate for Payer: BCN Commercial |
$32.72
|
| Rate for Payer: BCN Medicare Advantage |
$9.95
|
| Rate for Payer: Cash Price |
$31.84
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.95
|
| Rate for Payer: Healthscope Commercial |
$35.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.85
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.45
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.83
|
| Rate for Payer: Nomi Health Commercial |
$32.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.85
|
| Rate for Payer: PACE Senior Care Partners |
$9.45
|
| Rate for Payer: PACE SWMI |
$9.95
|
| Rate for Payer: PHP Commercial |
$33.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.63
|
| Rate for Payer: Priority Health Medicare |
$10.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.70
|
| Rate for Payer: Railroad Medicare Medicare |
$9.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.02
|
| Rate for Payer: UHC Core |
$33.23
|
| Rate for Payer: UHC Exchange |
$9.95
|
| Rate for Payer: UHC Medicaid |
$7.02
|
| Rate for Payer: UHC Medicare Advantage |
$9.95
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: VA VA |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.85
|
|
|
HC IMMUNODIFFUSION
|
Facility
|
OP
|
$127.97
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
30200191
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.56 |
| Max. Negotiated Rate |
$115.17 |
| Rate for Payer: Aetna Commercial |
$108.77
|
| Rate for Payer: Aetna Medicare |
$33.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.99
|
| Rate for Payer: BCBS Complete |
$23.69
|
| Rate for Payer: BCBS MAPPO |
$31.99
|
| Rate for Payer: BCBS Trust/PPO |
$105.20
|
| Rate for Payer: BCN Commercial |
$105.20
|
| Rate for Payer: BCN Medicare Advantage |
$31.99
|
| Rate for Payer: Cash Price |
$102.38
|
| Rate for Payer: Cofinity Commercial |
$110.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.99
|
| Rate for Payer: Healthscope Commercial |
$115.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.98
|
| Rate for Payer: Mclaren Medicaid |
$22.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.59
|
| Rate for Payer: Meridian Medicaid |
$23.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.77
|
| Rate for Payer: Nomi Health Commercial |
$104.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.98
|
| Rate for Payer: PACE Senior Care Partners |
$30.39
|
| Rate for Payer: PACE SWMI |
$31.99
|
| Rate for Payer: PHP Commercial |
$108.77
|
| Rate for Payer: PHP Medicare Advantage |
$31.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.33
|
| Rate for Payer: Priority Health Medicare |
$32.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.07
|
| Rate for Payer: Railroad Medicare Medicare |
$31.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.61
|
| Rate for Payer: UHC Core |
$106.85
|
| Rate for Payer: UHC Exchange |
$31.99
|
| Rate for Payer: UHC Medicaid |
$22.56
|
| Rate for Payer: UHC Medicare Advantage |
$31.99
|
| Rate for Payer: UHCCP Medicaid |
$22.56
|
| Rate for Payer: VA VA |
$31.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.98
|
|
|
HC IMMUNODIFFUSION
|
Facility
|
IP
|
$127.97
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
30200191
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$89.07 |
| Max. Negotiated Rate |
$115.17 |
| Rate for Payer: Aetna Commercial |
$108.77
|
| Rate for Payer: BCBS Trust/PPO |
$105.69
|
| Rate for Payer: BCN Commercial |
$105.69
|
| Rate for Payer: Cash Price |
$102.38
|
| Rate for Payer: Cofinity Commercial |
$110.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.38
|
| Rate for Payer: Healthscope Commercial |
$115.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.77
|
| Rate for Payer: Nomi Health Commercial |
$104.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.98
|
| Rate for Payer: PHP Commercial |
$108.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.61
|
| Rate for Payer: UHC Core |
$106.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.98
|
|
|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
IP
|
$80.65
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.13 |
| Max. Negotiated Rate |
$72.58 |
| Rate for Payer: Aetna Commercial |
$68.55
|
| Rate for Payer: BCBS Trust/PPO |
$66.61
|
| Rate for Payer: BCN Commercial |
$66.61
|
| Rate for Payer: Cash Price |
$64.52
|
| Rate for Payer: Cofinity Commercial |
$69.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.52
|
| Rate for Payer: Healthscope Commercial |
$72.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.55
|
| Rate for Payer: Nomi Health Commercial |
$66.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.49
|
| Rate for Payer: PHP Commercial |
$68.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.97
|
| Rate for Payer: UHC Core |
$67.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.49
|
|
|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
OP
|
$80.65
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.22 |
| Max. Negotiated Rate |
$72.58 |
| Rate for Payer: Aetna Commercial |
$68.55
|
| Rate for Payer: Aetna Medicare |
$20.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.20
|
| Rate for Payer: BCBS Complete |
$14.93
|
| Rate for Payer: BCBS MAPPO |
$20.16
|
| Rate for Payer: BCBS Trust/PPO |
$66.30
|
| Rate for Payer: BCN Commercial |
$66.30
|
| Rate for Payer: BCN Medicare Advantage |
$20.16
|
| Rate for Payer: Cash Price |
$64.52
|
| Rate for Payer: Cofinity Commercial |
$69.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.16
|
| Rate for Payer: Healthscope Commercial |
$72.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.49
|
| Rate for Payer: Mclaren Medicaid |
$14.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.17
|
| Rate for Payer: Meridian Medicaid |
$14.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.55
|
| Rate for Payer: Nomi Health Commercial |
$66.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.49
|
| Rate for Payer: PACE Senior Care Partners |
$19.15
|
| Rate for Payer: PACE SWMI |
$20.16
|
| Rate for Payer: PHP Commercial |
$68.55
|
| Rate for Payer: PHP Medicare Advantage |
$20.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.17
|
| Rate for Payer: Priority Health Medicare |
$20.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.13
|
| Rate for Payer: Railroad Medicare Medicare |
$20.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.97
|
| Rate for Payer: UHC Core |
$67.34
|
| Rate for Payer: UHC Exchange |
$20.16
|
| Rate for Payer: UHC Medicaid |
$14.22
|
| Rate for Payer: UHC Medicare Advantage |
$20.16
|
| Rate for Payer: UHCCP Medicaid |
$14.22
|
| Rate for Payer: VA VA |
$20.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.49
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
OP
|
$93.39
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.46 |
| Max. Negotiated Rate |
$84.05 |
| Rate for Payer: Aetna Commercial |
$79.38
|
| Rate for Payer: Aetna Medicare |
$24.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.18
|
| Rate for Payer: BCBS Complete |
$17.29
|
| Rate for Payer: BCBS MAPPO |
$23.35
|
| Rate for Payer: BCBS Trust/PPO |
$76.78
|
| Rate for Payer: BCN Commercial |
$76.78
|
| Rate for Payer: BCN Medicare Advantage |
$23.35
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.35
|
| Rate for Payer: Healthscope Commercial |
$84.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.04
|
| Rate for Payer: Mclaren Medicaid |
$16.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.51
|
| Rate for Payer: Meridian Medicaid |
$17.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.38
|
| Rate for Payer: Nomi Health Commercial |
$76.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.04
|
| Rate for Payer: PACE Senior Care Partners |
$22.18
|
| Rate for Payer: PACE SWMI |
$23.35
|
| Rate for Payer: PHP Commercial |
$79.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$23.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.00
|
| Rate for Payer: Railroad Medicare Medicare |
$23.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.18
|
| Rate for Payer: UHC Core |
$77.98
|
| Rate for Payer: UHC Exchange |
$23.35
|
| Rate for Payer: UHC Medicaid |
$16.46
|
| Rate for Payer: UHC Medicare Advantage |
$23.35
|
| Rate for Payer: UHCCP Medicaid |
$16.46
|
| Rate for Payer: VA VA |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.04
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
IP
|
$93.39
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$84.05 |
| Rate for Payer: Aetna Commercial |
$79.38
|
| Rate for Payer: BCBS Trust/PPO |
$77.13
|
| Rate for Payer: BCN Commercial |
$77.13
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.71
|
| Rate for Payer: Healthscope Commercial |
$84.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.38
|
| Rate for Payer: Nomi Health Commercial |
$76.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.04
|
| Rate for Payer: PHP Commercial |
$79.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.18
|
| Rate for Payer: UHC Core |
$77.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.04
|
|
|
HC IMMUNOFIXATION
|
Facility
|
OP
|
$93.39
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.46 |
| Max. Negotiated Rate |
$84.05 |
| Rate for Payer: Aetna Commercial |
$79.38
|
| Rate for Payer: Aetna Medicare |
$24.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.18
|
| Rate for Payer: BCBS Complete |
$17.29
|
| Rate for Payer: BCBS MAPPO |
$23.35
|
| Rate for Payer: BCBS Trust/PPO |
$76.78
|
| Rate for Payer: BCN Commercial |
$76.78
|
| Rate for Payer: BCN Medicare Advantage |
$23.35
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.35
|
| Rate for Payer: Healthscope Commercial |
$84.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.04
|
| Rate for Payer: Mclaren Medicaid |
$16.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.51
|
| Rate for Payer: Meridian Medicaid |
$17.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.38
|
| Rate for Payer: Nomi Health Commercial |
$76.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.04
|
| Rate for Payer: PACE Senior Care Partners |
$22.18
|
| Rate for Payer: PACE SWMI |
$23.35
|
| Rate for Payer: PHP Commercial |
$79.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$23.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.00
|
| Rate for Payer: Railroad Medicare Medicare |
$23.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.18
|
| Rate for Payer: UHC Core |
$77.98
|
| Rate for Payer: UHC Exchange |
$23.35
|
| Rate for Payer: UHC Medicaid |
$16.46
|
| Rate for Payer: UHC Medicare Advantage |
$23.35
|
| Rate for Payer: UHCCP Medicaid |
$16.46
|
| Rate for Payer: VA VA |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.04
|
|
|
HC IMMUNOFIXATION
|
Facility
|
IP
|
$93.39
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$84.05 |
| Rate for Payer: Aetna Commercial |
$79.38
|
| Rate for Payer: BCBS Trust/PPO |
$77.13
|
| Rate for Payer: BCN Commercial |
$77.13
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.71
|
| Rate for Payer: Healthscope Commercial |
$84.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.38
|
| Rate for Payer: Nomi Health Commercial |
$76.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.04
|
| Rate for Payer: PHP Commercial |
$79.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.18
|
| Rate for Payer: UHC Core |
$77.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.04
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
IP
|
$172.50
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.06 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: BCBS Trust/PPO |
$142.47
|
| Rate for Payer: BCN Commercial |
$142.47
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
OP
|
$172.50
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.41 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$44.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.91
|
| Rate for Payer: BCBS Complete |
$31.93
|
| Rate for Payer: BCBS MAPPO |
$43.12
|
| Rate for Payer: BCBS Trust/PPO |
$141.81
|
| Rate for Payer: BCN Commercial |
$141.81
|
| Rate for Payer: BCN Medicare Advantage |
$43.12
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.12
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Mclaren Medicaid |
$30.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.28
|
| Rate for Payer: Meridian Medicaid |
$31.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PACE Senior Care Partners |
$40.97
|
| Rate for Payer: PACE SWMI |
$43.12
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: PHP Medicare Advantage |
$43.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Medicare |
$43.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: Railroad Medicare Medicare |
$43.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: UHC Exchange |
$43.12
|
| Rate for Payer: UHC Medicaid |
$30.41
|
| Rate for Payer: UHC Medicare Advantage |
$43.12
|
| Rate for Payer: UHCCP Medicaid |
$30.41
|
| Rate for Payer: VA VA |
$43.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
IP
|
$172.50
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.06 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: BCBS Trust/PPO |
$142.47
|
| Rate for Payer: BCN Commercial |
$142.47
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
