|
HC INJ LUMB W MYELO CERV SAME MD
|
Facility
|
IP
|
$2,248.62
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
36100460
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,565.04 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,857.14
|
| Rate for Payer: BCN Commercial |
$1,857.14
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$1,843.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.79
|
| Rate for Payer: UHC Core |
$1,877.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO CERV SAME MD
|
Facility
|
OP
|
$2,248.62
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
36100460
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.43 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna Medicare |
$584.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$702.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$702.69
|
| Rate for Payer: BCBS Complete |
$416.22
|
| Rate for Payer: BCBS MAPPO |
$562.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,848.59
|
| Rate for Payer: BCN Commercial |
$1,848.59
|
| Rate for Payer: BCN Medicare Advantage |
$562.15
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.15
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Mclaren Medicaid |
$396.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.26
|
| Rate for Payer: Meridian Medicaid |
$416.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$1,843.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PACE Senior Care Partners |
$534.05
|
| Rate for Payer: PACE SWMI |
$562.15
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: PHP Medicare Advantage |
$562.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.30
|
| Rate for Payer: Priority Health Medicare |
$567.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.04
|
| Rate for Payer: Railroad Medicare Medicare |
$562.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.79
|
| Rate for Payer: UHC Core |
$1,877.60
|
| Rate for Payer: UHC Exchange |
$562.15
|
| Rate for Payer: UHC Medicaid |
$396.43
|
| Rate for Payer: UHC Medicare Advantage |
$562.15
|
| Rate for Payer: UHCCP Medicaid |
$396.43
|
| Rate for Payer: VA VA |
$562.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO LS SAME MD
|
Facility
|
OP
|
$2,248.62
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
36100462
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.43 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna Medicare |
$584.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$702.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$702.69
|
| Rate for Payer: BCBS Complete |
$416.22
|
| Rate for Payer: BCBS MAPPO |
$562.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,848.59
|
| Rate for Payer: BCN Commercial |
$1,848.59
|
| Rate for Payer: BCN Medicare Advantage |
$562.15
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.15
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Mclaren Medicaid |
$396.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.26
|
| Rate for Payer: Meridian Medicaid |
$416.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$1,843.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PACE Senior Care Partners |
$534.05
|
| Rate for Payer: PACE SWMI |
$562.15
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: PHP Medicare Advantage |
$562.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.30
|
| Rate for Payer: Priority Health Medicare |
$567.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.04
|
| Rate for Payer: Railroad Medicare Medicare |
$562.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.79
|
| Rate for Payer: UHC Core |
$1,877.60
|
| Rate for Payer: UHC Exchange |
$562.15
|
| Rate for Payer: UHC Medicaid |
$396.43
|
| Rate for Payer: UHC Medicare Advantage |
$562.15
|
| Rate for Payer: UHCCP Medicaid |
$396.43
|
| Rate for Payer: VA VA |
$562.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO LS SAME MD
|
Facility
|
IP
|
$2,248.62
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
36100462
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,565.04 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,857.14
|
| Rate for Payer: BCN Commercial |
$1,857.14
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$1,843.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.79
|
| Rate for Payer: UHC Core |
$1,877.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO THOR SAME MD
|
Facility
|
IP
|
$2,248.62
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
36100461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,565.04 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,857.14
|
| Rate for Payer: BCN Commercial |
$1,857.14
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$1,843.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.79
|
| Rate for Payer: UHC Core |
$1,877.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO THOR SAME MD
|
Facility
|
OP
|
$2,248.62
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
36100461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.43 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna Medicare |
$584.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$702.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$702.69
|
| Rate for Payer: BCBS Complete |
$416.22
|
| Rate for Payer: BCBS MAPPO |
$562.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,848.59
|
| Rate for Payer: BCN Commercial |
$1,848.59
|
| Rate for Payer: BCN Medicare Advantage |
$562.15
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.15
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Mclaren Medicaid |
$396.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.26
|
| Rate for Payer: Meridian Medicaid |
$416.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$1,843.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PACE Senior Care Partners |
$534.05
|
| Rate for Payer: PACE SWMI |
$562.15
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: PHP Medicare Advantage |
$562.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.30
|
| Rate for Payer: Priority Health Medicare |
$567.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.04
|
| Rate for Payer: Railroad Medicare Medicare |
$562.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.79
|
| Rate for Payer: UHC Core |
$1,877.60
|
| Rate for Payer: UHC Exchange |
$562.15
|
| Rate for Payer: UHC Medicaid |
$396.43
|
| Rate for Payer: UHC Medicare Advantage |
$562.15
|
| Rate for Payer: UHCCP Medicaid |
$396.43
|
| Rate for Payer: VA VA |
$562.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
IP
|
$1,331.27
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$926.56 |
| Max. Negotiated Rate |
$1,198.14 |
| Rate for Payer: Aetna Commercial |
$1,131.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.50
|
| Rate for Payer: BCN Commercial |
$1,099.50
|
| Rate for Payer: Cash Price |
$1,065.02
|
| Rate for Payer: Cofinity Commercial |
$1,144.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.02
|
| Rate for Payer: Healthscope Commercial |
$1,198.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.58
|
| Rate for Payer: Nomi Health Commercial |
$1,091.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.45
|
| Rate for Payer: PHP Commercial |
$1,131.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,158.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.52
|
| Rate for Payer: UHC Core |
$1,111.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.45
|
|
|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
OP
|
$1,331.27
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$234.70 |
| Max. Negotiated Rate |
$1,198.14 |
| Rate for Payer: Aetna Commercial |
$1,131.58
|
| Rate for Payer: Aetna Medicare |
$346.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$416.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$416.02
|
| Rate for Payer: BCBS Complete |
$246.42
|
| Rate for Payer: BCBS MAPPO |
$332.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.44
|
| Rate for Payer: BCN Commercial |
$1,094.44
|
| Rate for Payer: BCN Medicare Advantage |
$332.82
|
| Rate for Payer: Cash Price |
$1,065.02
|
| Rate for Payer: Cofinity Commercial |
$1,144.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.82
|
| Rate for Payer: Healthscope Commercial |
$1,198.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.45
|
| Rate for Payer: Mclaren Medicaid |
$234.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.46
|
| Rate for Payer: Meridian Medicaid |
$246.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$366.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.58
|
| Rate for Payer: Nomi Health Commercial |
$1,091.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.45
|
| Rate for Payer: PACE Senior Care Partners |
$316.18
|
| Rate for Payer: PACE SWMI |
$332.82
|
| Rate for Payer: PHP Commercial |
$1,131.58
|
| Rate for Payer: PHP Medicare Advantage |
$332.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,158.20
|
| Rate for Payer: Priority Health Medicare |
$336.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.56
|
| Rate for Payer: Railroad Medicare Medicare |
$332.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.52
|
| Rate for Payer: UHC Core |
$1,111.61
|
| Rate for Payer: UHC Exchange |
$332.82
|
| Rate for Payer: UHC Medicaid |
$234.70
|
| Rate for Payer: UHC Medicare Advantage |
$332.82
|
| Rate for Payer: UHCCP Medicaid |
$234.70
|
| Rate for Payer: VA VA |
$332.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.45
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
OP
|
$0.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Aetna Commercial |
$0.45
|
| Rate for Payer: Aetna Medicare |
$0.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.17
|
| Rate for Payer: BCBS Complete |
$0.10
|
| Rate for Payer: BCBS MAPPO |
$0.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Medicare Advantage |
$0.13
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.40
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.14
|
| Rate for Payer: Meridian Medicaid |
$0.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.45
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.40
|
| Rate for Payer: PACE Senior Care Partners |
$0.13
|
| Rate for Payer: PACE SWMI |
$0.13
|
| Rate for Payer: PHP Commercial |
$0.45
|
| Rate for Payer: PHP Medicare Advantage |
$0.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.46
|
| Rate for Payer: Priority Health Medicare |
$0.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.47
|
| Rate for Payer: UHC Core |
$0.44
|
| Rate for Payer: UHC Exchange |
$0.13
|
| Rate for Payer: UHC Medicaid |
$0.09
|
| Rate for Payer: UHC Medicare Advantage |
$0.13
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: VA VA |
$0.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.40
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
IP
|
$0.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Aetna Commercial |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.45
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.40
|
| Rate for Payer: PHP Commercial |
$0.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.47
|
| Rate for Payer: UHC Core |
$0.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.40
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$2.19
|
| Rate for Payer: BCN Commercial |
$2.19
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.33
|
| Rate for Payer: UHC Core |
$2.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna Medicare |
$0.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.83
|
| Rate for Payer: BCBS Complete |
$0.49
|
| Rate for Payer: BCBS MAPPO |
$0.66
|
| Rate for Payer: BCBS Trust/PPO |
$2.18
|
| Rate for Payer: BCN Commercial |
$2.18
|
| Rate for Payer: BCN Medicare Advantage |
$0.66
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.66
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Mclaren Medicaid |
$0.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.70
|
| Rate for Payer: Meridian Medicaid |
$0.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PACE Senior Care Partners |
$0.63
|
| Rate for Payer: PACE SWMI |
$0.66
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$0.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.31
|
| Rate for Payer: Priority Health Medicare |
$0.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.84
|
| Rate for Payer: Railroad Medicare Medicare |
$0.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.33
|
| Rate for Payer: UHC Core |
$2.21
|
| Rate for Payer: UHC Exchange |
$0.66
|
| Rate for Payer: UHC Medicaid |
$0.47
|
| Rate for Payer: UHC Medicare Advantage |
$0.66
|
| Rate for Payer: UHCCP Medicaid |
$0.47
|
| Rate for Payer: VA VA |
$0.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
OP
|
$269.67
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.54 |
| Max. Negotiated Rate |
$242.70 |
| Rate for Payer: Aetna Commercial |
$229.22
|
| Rate for Payer: Aetna Commercial |
$343.82
|
| Rate for Payer: Aetna Medicare |
$105.17
|
| Rate for Payer: Aetna Medicare |
$70.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.41
|
| Rate for Payer: BCBS Complete |
$49.92
|
| Rate for Payer: BCBS Complete |
$74.87
|
| Rate for Payer: BCBS MAPPO |
$67.42
|
| Rate for Payer: BCBS MAPPO |
$101.12
|
| Rate for Payer: BCBS Trust/PPO |
$221.70
|
| Rate for Payer: BCBS Trust/PPO |
$332.54
|
| Rate for Payer: BCN Commercial |
$332.54
|
| Rate for Payer: BCN Commercial |
$221.70
|
| Rate for Payer: BCN Medicare Advantage |
$101.12
|
| Rate for Payer: BCN Medicare Advantage |
$67.42
|
| Rate for Payer: Cash Price |
$215.74
|
| Rate for Payer: Cash Price |
$323.60
|
| Rate for Payer: Cofinity Commercial |
$231.92
|
| Rate for Payer: Cofinity Commercial |
$347.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$242.70
|
| Rate for Payer: Healthscope Commercial |
$364.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.38
|
| Rate for Payer: Mclaren Medicaid |
$71.31
|
| Rate for Payer: Mclaren Medicaid |
$47.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.79
|
| Rate for Payer: Meridian Medicaid |
$49.92
|
| Rate for Payer: Meridian Medicaid |
$74.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.22
|
| Rate for Payer: Nomi Health Commercial |
$331.69
|
| Rate for Payer: Nomi Health Commercial |
$221.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.38
|
| Rate for Payer: PACE Senior Care Partners |
$96.07
|
| Rate for Payer: PACE Senior Care Partners |
$64.05
|
| Rate for Payer: PACE SWMI |
$101.12
|
| Rate for Payer: PACE SWMI |
$67.42
|
| Rate for Payer: PHP Commercial |
$229.22
|
| Rate for Payer: PHP Commercial |
$343.82
|
| Rate for Payer: PHP Medicare Advantage |
$67.42
|
| Rate for Payer: PHP Medicare Advantage |
$101.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$351.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$234.61
|
| Rate for Payer: Priority Health Medicare |
$102.14
|
| Rate for Payer: Priority Health Medicare |
$68.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.53
|
| Rate for Payer: Railroad Medicare Medicare |
$67.42
|
| Rate for Payer: Railroad Medicare Medicare |
$101.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.96
|
| Rate for Payer: UHC Core |
$337.76
|
| Rate for Payer: UHC Core |
$225.17
|
| Rate for Payer: UHC Exchange |
$101.12
|
| Rate for Payer: UHC Exchange |
$67.42
|
| Rate for Payer: UHC Medicaid |
$71.31
|
| Rate for Payer: UHC Medicaid |
$47.54
|
| Rate for Payer: UHC Medicare Advantage |
$67.42
|
| Rate for Payer: UHC Medicare Advantage |
$101.12
|
| Rate for Payer: UHCCP Medicaid |
$47.54
|
| Rate for Payer: UHCCP Medicaid |
$71.31
|
| Rate for Payer: VA VA |
$67.42
|
| Rate for Payer: VA VA |
$101.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.25
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
IP
|
$269.67
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.69 |
| Max. Negotiated Rate |
$242.70 |
| Rate for Payer: Aetna Commercial |
$229.22
|
| Rate for Payer: Aetna Commercial |
$343.82
|
| Rate for Payer: BCBS Trust/PPO |
$222.72
|
| Rate for Payer: BCBS Trust/PPO |
$334.08
|
| Rate for Payer: BCN Commercial |
$222.72
|
| Rate for Payer: BCN Commercial |
$334.08
|
| Rate for Payer: Cash Price |
$215.74
|
| Rate for Payer: Cash Price |
$323.60
|
| Rate for Payer: Cofinity Commercial |
$347.87
|
| Rate for Payer: Cofinity Commercial |
$231.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.74
|
| Rate for Payer: Healthscope Commercial |
$242.70
|
| Rate for Payer: Healthscope Commercial |
$364.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.82
|
| Rate for Payer: Nomi Health Commercial |
$221.13
|
| Rate for Payer: Nomi Health Commercial |
$331.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.38
|
| Rate for Payer: PHP Commercial |
$343.82
|
| Rate for Payer: PHP Commercial |
$229.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$351.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$234.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.96
|
| Rate for Payer: UHC Core |
$225.17
|
| Rate for Payer: UHC Core |
$337.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.38
|
|
|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
IP
|
$8.32
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: BCBS Trust/PPO |
$6.87
|
| Rate for Payer: BCN Commercial |
$6.87
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.32
|
| Rate for Payer: UHC Core |
$6.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.24
|
|
|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
OP
|
$8.32
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: Aetna Medicare |
$2.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.60
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: BCBS MAPPO |
$2.08
|
| Rate for Payer: BCBS Trust/PPO |
$6.84
|
| Rate for Payer: BCN Commercial |
$6.84
|
| Rate for Payer: BCN Medicare Advantage |
$2.08
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.24
|
| Rate for Payer: Mclaren Medicaid |
$1.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.18
|
| Rate for Payer: Meridian Medicaid |
$1.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PACE Senior Care Partners |
$1.98
|
| Rate for Payer: PACE SWMI |
$2.08
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: PHP Medicare Advantage |
$2.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.24
|
| Rate for Payer: Priority Health Medicare |
$2.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.32
|
| Rate for Payer: UHC Core |
$6.95
|
| Rate for Payer: UHC Exchange |
$2.08
|
| Rate for Payer: UHC Medicaid |
$1.47
|
| Rate for Payer: UHC Medicare Advantage |
$2.08
|
| Rate for Payer: UHCCP Medicaid |
$1.47
|
| Rate for Payer: VA VA |
$2.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.24
|
|
|
HC INJ PEN G BENZATHINE/PROCAINE 100,000 UNITS
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS J0558
|
| Hospital Charge Code |
63600271
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.76 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$49.55
|
| Rate for Payer: BCN Commercial |
$49.55
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.00
|
| Rate for Payer: Nomi Health Commercial |
$49.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC INJ PEN G BENZATHINE/PROCAINE 100,000 UNITS
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS J0558
|
| Hospital Charge Code |
63600271
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$15.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.75
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: BCBS MAPPO |
$15.00
|
| Rate for Payer: BCBS Trust/PPO |
$49.33
|
| Rate for Payer: BCN Commercial |
$49.33
|
| Rate for Payer: BCN Medicare Advantage |
$15.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Mclaren Medicaid |
$10.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.75
|
| Rate for Payer: Meridian Medicaid |
$11.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.00
|
| Rate for Payer: Nomi Health Commercial |
$49.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.00
|
| Rate for Payer: PACE Senior Care Partners |
$14.25
|
| Rate for Payer: PACE SWMI |
$15.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$15.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.20
|
| Rate for Payer: Priority Health Medicare |
$15.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: UHC Exchange |
$15.00
|
| Rate for Payer: UHC Medicaid |
$10.58
|
| Rate for Payer: UHC Medicare Advantage |
$15.00
|
| Rate for Payer: UHCCP Medicaid |
$10.58
|
| Rate for Payer: VA VA |
$15.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
OP
|
$17.52
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$15.77 |
| Rate for Payer: Aetna Commercial |
$14.89
|
| Rate for Payer: Aetna Medicare |
$4.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.47
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCBS Trust/PPO |
$14.40
|
| Rate for Payer: BCN Commercial |
$14.40
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$15.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$15.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.14
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.89
|
| Rate for Payer: Nomi Health Commercial |
$14.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.14
|
| Rate for Payer: PACE Senior Care Partners |
$4.16
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Commercial |
$14.89
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.24
|
| Rate for Payer: Priority Health Medicare |
$4.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.19
|
| Rate for Payer: Railroad Medicare Medicare |
$4.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.42
|
| Rate for Payer: UHC Core |
$14.63
|
| Rate for Payer: UHC Exchange |
$4.38
|
| Rate for Payer: UHC Medicaid |
$3.09
|
| Rate for Payer: UHC Medicare Advantage |
$4.38
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$4.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.14
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
IP
|
$17.52
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$15.77 |
| Rate for Payer: Aetna Commercial |
$14.89
|
| Rate for Payer: BCBS Trust/PPO |
$14.47
|
| Rate for Payer: BCN Commercial |
$14.47
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$15.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$15.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.89
|
| Rate for Payer: Nomi Health Commercial |
$14.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.14
|
| Rate for Payer: PHP Commercial |
$14.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.42
|
| Rate for Payer: UHC Core |
$14.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.14
|
|
|
HC INJ PROCHLORPERAZINE UP TO 10 MG
|
Facility
|
OP
|
$79.78
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
63600246
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$71.80 |
| Rate for Payer: Aetna Commercial |
$67.81
|
| Rate for Payer: Aetna Medicare |
$20.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.93
|
| Rate for Payer: BCBS Complete |
$14.77
|
| Rate for Payer: BCBS MAPPO |
$19.95
|
| Rate for Payer: BCBS Trust/PPO |
$65.59
|
| Rate for Payer: BCN Commercial |
$65.59
|
| Rate for Payer: BCN Medicare Advantage |
$19.95
|
| Rate for Payer: Cash Price |
$63.82
|
| Rate for Payer: Cofinity Commercial |
$68.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.95
|
| Rate for Payer: Healthscope Commercial |
$71.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.84
|
| Rate for Payer: Mclaren Medicaid |
$14.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.94
|
| Rate for Payer: Meridian Medicaid |
$14.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.81
|
| Rate for Payer: Nomi Health Commercial |
$65.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.95
|
| Rate for Payer: PACE SWMI |
$19.95
|
| Rate for Payer: PHP Commercial |
$67.81
|
| Rate for Payer: PHP Medicare Advantage |
$19.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.41
|
| Rate for Payer: Priority Health Medicare |
$20.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.21
|
| Rate for Payer: UHC Core |
$66.62
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicaid |
$14.07
|
| Rate for Payer: UHC Medicare Advantage |
$19.95
|
| Rate for Payer: UHCCP Medicaid |
$14.07
|
| Rate for Payer: VA VA |
$19.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.84
|
|
