|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
IP
|
$1,305.17
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.36 |
| Max. Negotiated Rate |
$1,174.65 |
| Rate for Payer: Aetna Commercial |
$1,109.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.41
|
| Rate for Payer: BCN Commercial |
$1,008.64
|
| Rate for Payer: Cash Price |
$1,044.14
|
| Rate for Payer: Cofinity Commercial |
$1,122.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,044.14
|
| Rate for Payer: Healthscope Commercial |
$1,174.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$978.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,109.39
|
| Rate for Payer: Nomi Health Commercial |
$1,070.24
|
| Rate for Payer: PHP Commercial |
$1,109.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,135.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$874.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,148.55
|
| Rate for Payer: UHC Core |
$1,089.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$978.88
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
OP
|
$0.52
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.47 |
| Rate for Payer: Aetna Commercial |
$0.44
|
| Rate for Payer: Aetna Medicare |
$0.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS MAPPO |
$0.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.43
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: BCN Medicare Advantage |
$0.13
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.45
|
| 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 |
$0.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.39
|
| 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 |
$0.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: PACE Senior Care Partners |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.13
|
| Rate for Payer: PHP Commercial |
$0.44
|
| 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 |
$0.34
|
| Rate for Payer: Priority Health HMO/PPO |
$0.45
|
| Rate for Payer: Priority Health Medicare |
$0.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.35
|
| Rate for Payer: Railroad Medicare Medicare |
$0.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.13
|
| Rate for Payer: UHC Exchange |
$0.13
|
| 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 |
$0.39
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
IP
|
$0.52
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$0.47 |
| Rate for Payer: Aetna Commercial |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.42
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: PHP Commercial |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: Priority Health HMO/PPO |
$0.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.39
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
IP
|
$2.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$2.34 |
| Rate for Payer: Aetna Commercial |
$2.21
|
| Rate for Payer: BCBS Trust/PPO |
$2.12
|
| Rate for Payer: BCN Commercial |
$2.01
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$2.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.21
|
| Rate for Payer: Nomi Health Commercial |
$2.13
|
| Rate for Payer: PHP Commercial |
$2.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.69
|
| Rate for Payer: Priority Health HMO/PPO |
$2.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.29
|
| Rate for Payer: UHC Core |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.95
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
OP
|
$2.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$2.34 |
| Rate for Payer: Aetna Commercial |
$2.21
|
| Rate for Payer: Aetna Medicare |
$0.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$0.65
|
| Rate for Payer: BCBS Trust/PPO |
$2.14
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.65
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.65
|
| Rate for Payer: Healthscope Commercial |
$2.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.95
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.68
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.21
|
| Rate for Payer: Nomi Health Commercial |
$2.13
|
| Rate for Payer: PACE Senior Care Partners |
$0.62
|
| Rate for Payer: PACE SWMI |
$0.65
|
| Rate for Payer: PHP Commercial |
$2.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.69
|
| Rate for Payer: Priority Health HMO/PPO |
$2.26
|
| Rate for Payer: Priority Health Medicare |
$0.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.74
|
| Rate for Payer: Railroad Medicare Medicare |
$0.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.29
|
| Rate for Payer: UHC Core |
$2.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.65
|
| Rate for Payer: UHC Exchange |
$0.65
|
| Rate for Payer: UHC Medicare Advantage |
$0.65
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$0.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.95
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
OP
|
$264.38
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.79 |
| Max. Negotiated Rate |
$237.94 |
| Rate for Payer: Aetna Commercial |
$224.72
|
| Rate for Payer: Aetna Medicare |
$68.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.62
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$66.09
|
| Rate for Payer: BCBS Trust/PPO |
$217.35
|
| Rate for Payer: BCN Commercial |
$205.56
|
| Rate for Payer: BCN Medicare Advantage |
$66.09
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cofinity Commercial |
$227.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.09
|
| Rate for Payer: Healthscope Commercial |
$237.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.28
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.40
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.72
|
| Rate for Payer: Nomi Health Commercial |
$216.79
|
| Rate for Payer: PACE Senior Care Partners |
$62.79
|
| Rate for Payer: PACE SWMI |
$66.09
|
| Rate for Payer: PHP Commercial |
$224.72
|
| Rate for Payer: PHP Medicare Advantage |
$66.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.85
|
| Rate for Payer: Priority Health HMO/PPO |
$230.01
|
| Rate for Payer: Priority Health Medicare |
$66.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.13
|
| Rate for Payer: Railroad Medicare Medicare |
$66.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.65
|
| Rate for Payer: UHC Core |
$220.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.09
|
| Rate for Payer: UHC Exchange |
$66.09
|
| Rate for Payer: UHC Medicare Advantage |
$66.09
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$66.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.28
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
IP
|
$264.38
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.85 |
| Max. Negotiated Rate |
$237.94 |
| Rate for Payer: Aetna Commercial |
$224.72
|
| Rate for Payer: BCBS Trust/PPO |
$215.81
|
| Rate for Payer: BCN Commercial |
$204.31
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cofinity Commercial |
$227.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.50
|
| Rate for Payer: Healthscope Commercial |
$237.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.72
|
| Rate for Payer: Nomi Health Commercial |
$216.79
|
| Rate for Payer: PHP Commercial |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.85
|
| Rate for Payer: Priority Health HMO/PPO |
$230.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.65
|
| Rate for Payer: UHC Core |
$220.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.28
|
|
|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
IP
|
$8.16
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$7.34 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: BCBS Trust/PPO |
$6.66
|
| Rate for Payer: BCN Commercial |
$6.31
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$7.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: PHP Commercial |
$6.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health HMO/PPO |
$7.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.18
|
| Rate for Payer: UHC Core |
$6.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.12
|
|
|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
OP
|
$8.16
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$7.34 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$2.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.55
|
| Rate for Payer: BCBS Complete |
$4.93
|
| Rate for Payer: BCBS MAPPO |
$2.04
|
| Rate for Payer: BCBS Trust/PPO |
$6.71
|
| Rate for Payer: BCN Commercial |
$6.34
|
| Rate for Payer: BCN Medicare Advantage |
$2.04
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.04
|
| Rate for Payer: Healthscope Commercial |
$7.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.12
|
| Rate for Payer: Mclaren Medicaid |
$4.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.14
|
| Rate for Payer: Meridian Medicaid |
$4.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: PACE Senior Care Partners |
$1.94
|
| Rate for Payer: PACE SWMI |
$2.04
|
| Rate for Payer: PHP Commercial |
$6.94
|
| Rate for Payer: PHP Medicare Advantage |
$2.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health HMO/PPO |
$7.10
|
| Rate for Payer: Priority Health Medicare |
$2.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.47
|
| Rate for Payer: Railroad Medicare Medicare |
$2.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.18
|
| Rate for Payer: UHC Core |
$6.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.04
|
| Rate for Payer: UHC Exchange |
$2.04
|
| Rate for Payer: UHC Medicare Advantage |
$2.04
|
| Rate for Payer: UHCCP Medicaid |
$4.70
|
| Rate for Payer: VA VA |
$2.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.12
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
OP
|
$17.18
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$14.60
|
| Rate for Payer: Aetna Medicare |
$4.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.37
|
| Rate for Payer: BCBS Complete |
$22.78
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$14.12
|
| Rate for Payer: BCN Commercial |
$13.36
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cofinity Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$15.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.88
|
| Rate for Payer: Mclaren Medicaid |
$21.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.51
|
| Rate for Payer: Meridian Medicaid |
$22.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.60
|
| Rate for Payer: Nomi Health Commercial |
$14.09
|
| Rate for Payer: PACE Senior Care Partners |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$14.60
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.17
|
| Rate for Payer: Priority Health HMO/PPO |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$4.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.51
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Core |
$14.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.29
|
| Rate for Payer: UHC Exchange |
$4.29
|
| Rate for Payer: UHC Medicare Advantage |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$21.70
|
| Rate for Payer: VA VA |
$4.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.88
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
IP
|
$17.18
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$15.46 |
| Rate for Payer: Aetna Commercial |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.02
|
| Rate for Payer: BCN Commercial |
$13.28
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cofinity Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$15.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.60
|
| Rate for Payer: Nomi Health Commercial |
$14.09
|
| Rate for Payer: PHP Commercial |
$14.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.17
|
| Rate for Payer: Priority Health HMO/PPO |
$14.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Core |
$14.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.88
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
OP
|
$683.54
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$162.34 |
| Max. Negotiated Rate |
$615.19 |
| Rate for Payer: Aetna Commercial |
$581.01
|
| Rate for Payer: Aetna Medicare |
$177.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$213.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$213.61
|
| Rate for Payer: BCBS Complete |
$273.42
|
| Rate for Payer: BCBS MAPPO |
$170.88
|
| Rate for Payer: BCBS Trust/PPO |
$561.94
|
| Rate for Payer: BCN Commercial |
$531.45
|
| Rate for Payer: BCN Medicare Advantage |
$170.88
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.88
|
| Rate for Payer: Healthscope Commercial |
$615.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.01
|
| Rate for Payer: Nomi Health Commercial |
$560.50
|
| Rate for Payer: PACE Senior Care Partners |
$162.34
|
| Rate for Payer: PACE SWMI |
$170.88
|
| Rate for Payer: PHP Commercial |
$581.01
|
| Rate for Payer: PHP Medicare Advantage |
$170.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.30
|
| Rate for Payer: Priority Health HMO/PPO |
$594.68
|
| Rate for Payer: Priority Health Medicare |
$172.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.97
|
| Rate for Payer: Railroad Medicare Medicare |
$170.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$601.52
|
| Rate for Payer: UHC Core |
$570.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.88
|
| Rate for Payer: UHC Exchange |
$170.88
|
| Rate for Payer: UHC Medicare Advantage |
$170.88
|
| Rate for Payer: VA VA |
$170.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.65
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
IP
|
$683.54
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$444.30 |
| Max. Negotiated Rate |
$615.19 |
| Rate for Payer: Aetna Commercial |
$581.01
|
| Rate for Payer: BCBS Trust/PPO |
$557.97
|
| Rate for Payer: BCN Commercial |
$528.24
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.83
|
| Rate for Payer: Healthscope Commercial |
$615.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.01
|
| Rate for Payer: Nomi Health Commercial |
$560.50
|
| Rate for Payer: PHP Commercial |
$581.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.30
|
| Rate for Payer: Priority Health HMO/PPO |
$594.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$601.52
|
| Rate for Payer: UHC Core |
$570.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.65
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: BCBS Trust/PPO |
$169.86
|
| Rate for Payer: BCN Commercial |
$160.80
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.03
|
| Rate for Payer: BCBS Complete |
$83.23
|
| Rate for Payer: BCBS MAPPO |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$171.06
|
| Rate for Payer: BCN Commercial |
$161.78
|
| Rate for Payer: BCN Medicare Advantage |
$52.02
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PACE Senior Care Partners |
$49.42
|
| Rate for Payer: PACE SWMI |
$52.02
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Medicare |
$52.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: Railroad Medicare Medicare |
$52.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.02
|
| Rate for Payer: UHC Exchange |
$52.02
|
| Rate for Payer: UHC Medicare Advantage |
$52.02
|
| Rate for Payer: VA VA |
$52.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$2.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.25
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: BCBS MAPPO |
$2.60
|
| Rate for Payer: BCBS Trust/PPO |
$8.55
|
| Rate for Payer: BCN Commercial |
$8.09
|
| Rate for Payer: BCN Medicare Advantage |
$2.60
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.60
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: PACE Senior Care Partners |
$2.47
|
| Rate for Payer: PACE SWMI |
$2.60
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: PHP Medicare Advantage |
$2.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health HMO/PPO |
$9.05
|
| Rate for Payer: Priority Health Medicare |
$2.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.15
|
| Rate for Payer: UHC Core |
$8.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.60
|
| Rate for Payer: UHC Exchange |
$2.60
|
| Rate for Payer: UHC Medicare Advantage |
$2.60
|
| Rate for Payer: VA VA |
$2.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$8.49
|
| Rate for Payer: BCN Commercial |
$8.04
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health HMO/PPO |
$9.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.15
|
| Rate for Payer: UHC Core |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
OP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: Aetna Medicare |
$1.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.62
|
| Rate for Payer: BCBS Complete |
$2.08
|
| Rate for Payer: BCBS MAPPO |
$1.30
|
| Rate for Payer: BCBS Trust/PPO |
$4.27
|
| Rate for Payer: BCN Commercial |
$4.04
|
| Rate for Payer: BCN Medicare Advantage |
$1.30
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$4.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.30
|
| Rate for Payer: Healthscope Commercial |
$4.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.26
|
| Rate for Payer: PACE Senior Care Partners |
$1.24
|
| Rate for Payer: PACE SWMI |
$1.30
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: PHP Medicare Advantage |
$1.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health HMO/PPO |
$4.52
|
| Rate for Payer: Priority Health Medicare |
$1.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.58
|
| Rate for Payer: UHC Core |
$4.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.30
|
| Rate for Payer: UHC Exchange |
$1.30
|
| Rate for Payer: UHC Medicare Advantage |
$1.30
|
| Rate for Payer: VA VA |
$1.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.90
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
IP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: BCBS Trust/PPO |
$4.24
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$4.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$4.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.26
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health HMO/PPO |
$4.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.58
|
| Rate for Payer: UHC Core |
$4.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.90
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
