|
HC MUGWORT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MUGWORT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MULBERRY IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MULBERRY IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MULTIDNA LYME/UREAPLASMA
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600354
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Commercial |
$110.50
|
| Rate for Payer: Aetna Medicare |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.62
|
| Rate for Payer: BCBS Complete |
$24.06
|
| Rate for Payer: BCBS MAPPO |
$32.50
|
| Rate for Payer: BCBS Trust/PPO |
$106.87
|
| Rate for Payer: BCN Commercial |
$106.87
|
| Rate for Payer: BCN Medicare Advantage |
$32.50
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$111.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.50
|
| Rate for Payer: Healthscope Commercial |
$117.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.50
|
| Rate for Payer: Mclaren Medicaid |
$22.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.12
|
| Rate for Payer: Meridian Medicaid |
$24.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.50
|
| Rate for Payer: Nomi Health Commercial |
$106.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE Senior Care Partners |
$30.88
|
| Rate for Payer: PACE SWMI |
$32.50
|
| Rate for Payer: PHP Commercial |
$110.50
|
| Rate for Payer: PHP Medicare Advantage |
$32.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.10
|
| Rate for Payer: Priority Health Medicare |
$32.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.48
|
| Rate for Payer: Railroad Medicare Medicare |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.40
|
| Rate for Payer: UHC Core |
$108.55
|
| Rate for Payer: UHC Exchange |
$32.50
|
| Rate for Payer: UHC Medicaid |
$22.92
|
| Rate for Payer: UHC Medicare Advantage |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$22.92
|
| Rate for Payer: VA VA |
$32.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.50
|
|
|
HC MULTIDNA LYME/UREAPLASMA
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600354
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.48 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Commercial |
$110.50
|
| Rate for Payer: BCBS Trust/PPO |
$107.37
|
| Rate for Payer: BCN Commercial |
$107.37
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$111.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.00
|
| Rate for Payer: Healthscope Commercial |
$117.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.50
|
| Rate for Payer: Nomi Health Commercial |
$106.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PHP Commercial |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.40
|
| Rate for Payer: UHC Core |
$108.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.50
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$6.81
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$6.13 |
| Rate for Payer: Aetna Commercial |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$5.62
|
| Rate for Payer: BCN Commercial |
$5.62
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: Cofinity Commercial |
$5.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.45
|
| Rate for Payer: Healthscope Commercial |
$6.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.79
|
| Rate for Payer: Nomi Health Commercial |
$5.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.11
|
| Rate for Payer: PHP Commercial |
$5.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.99
|
| Rate for Payer: UHC Core |
$5.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.11
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
OP
|
$6.81
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$6.13 |
| Rate for Payer: Aetna Commercial |
$5.79
|
| Rate for Payer: Aetna Medicare |
$1.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.13
|
| Rate for Payer: BCBS Complete |
$1.26
|
| Rate for Payer: BCBS MAPPO |
$1.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.60
|
| Rate for Payer: BCN Commercial |
$5.60
|
| Rate for Payer: BCN Medicare Advantage |
$1.70
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: Cofinity Commercial |
$5.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.70
|
| Rate for Payer: Healthscope Commercial |
$6.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.11
|
| Rate for Payer: Mclaren Medicaid |
$1.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.79
|
| Rate for Payer: Meridian Medicaid |
$1.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.79
|
| Rate for Payer: Nomi Health Commercial |
$5.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.11
|
| Rate for Payer: PACE Senior Care Partners |
$1.62
|
| Rate for Payer: PACE SWMI |
$1.70
|
| Rate for Payer: PHP Commercial |
$5.79
|
| Rate for Payer: PHP Medicare Advantage |
$1.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.92
|
| Rate for Payer: Priority Health Medicare |
$1.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.99
|
| Rate for Payer: UHC Core |
$5.69
|
| Rate for Payer: UHC Exchange |
$1.70
|
| Rate for Payer: UHC Medicaid |
$1.20
|
| Rate for Payer: UHC Medicare Advantage |
$1.70
|
| Rate for Payer: UHCCP Medicaid |
$1.20
|
| Rate for Payer: VA VA |
$1.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.11
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$654.41
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$455.47 |
| Max. Negotiated Rate |
$588.97 |
| Rate for Payer: Aetna Commercial |
$556.25
|
| Rate for Payer: BCBS Trust/PPO |
$540.48
|
| Rate for Payer: BCN Commercial |
$540.48
|
| Rate for Payer: Cash Price |
$523.53
|
| Rate for Payer: Cofinity Commercial |
$562.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$523.53
|
| Rate for Payer: Healthscope Commercial |
$588.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.25
|
| Rate for Payer: Nomi Health Commercial |
$536.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.81
|
| Rate for Payer: PHP Commercial |
$556.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$569.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$455.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.88
|
| Rate for Payer: UHC Core |
$546.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.81
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$654.41
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$115.37 |
| Max. Negotiated Rate |
$588.97 |
| Rate for Payer: Aetna Commercial |
$556.25
|
| Rate for Payer: Aetna Medicare |
$170.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.50
|
| Rate for Payer: BCBS Complete |
$121.13
|
| Rate for Payer: BCBS MAPPO |
$163.60
|
| Rate for Payer: BCBS Trust/PPO |
$537.99
|
| Rate for Payer: BCN Commercial |
$537.99
|
| Rate for Payer: BCN Medicare Advantage |
$163.60
|
| Rate for Payer: Cash Price |
$523.53
|
| Rate for Payer: Cofinity Commercial |
$562.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$523.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.60
|
| Rate for Payer: Healthscope Commercial |
$588.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.81
|
| Rate for Payer: Mclaren Medicaid |
$115.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.78
|
| Rate for Payer: Meridian Medicaid |
$121.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.25
|
| Rate for Payer: Nomi Health Commercial |
$536.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.81
|
| Rate for Payer: PACE Senior Care Partners |
$155.42
|
| Rate for Payer: PACE SWMI |
$163.60
|
| Rate for Payer: PHP Commercial |
$556.25
|
| Rate for Payer: PHP Medicare Advantage |
$163.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$569.34
|
| Rate for Payer: Priority Health Medicare |
$165.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$455.47
|
| Rate for Payer: Railroad Medicare Medicare |
$163.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.88
|
| Rate for Payer: UHC Core |
$546.43
|
| Rate for Payer: UHC Exchange |
$163.60
|
| Rate for Payer: UHC Medicaid |
$115.37
|
| Rate for Payer: UHC Medicare Advantage |
$163.60
|
| Rate for Payer: UHCCP Medicaid |
$115.37
|
| Rate for Payer: VA VA |
$163.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.81
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
OP
|
$870.19
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$153.41 |
| Max. Negotiated Rate |
$783.17 |
| Rate for Payer: Aetna Commercial |
$739.66
|
| Rate for Payer: Aetna Medicare |
$226.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.93
|
| Rate for Payer: BCBS Complete |
$161.07
|
| Rate for Payer: BCBS MAPPO |
$217.55
|
| Rate for Payer: BCBS Trust/PPO |
$715.38
|
| Rate for Payer: BCN Commercial |
$715.38
|
| Rate for Payer: BCN Medicare Advantage |
$217.55
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cofinity Commercial |
$748.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.55
|
| Rate for Payer: Healthscope Commercial |
$783.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.64
|
| Rate for Payer: Mclaren Medicaid |
$153.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.42
|
| Rate for Payer: Meridian Medicaid |
$161.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.66
|
| Rate for Payer: Nomi Health Commercial |
$713.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$652.64
|
| Rate for Payer: PACE Senior Care Partners |
$206.67
|
| Rate for Payer: PACE SWMI |
$217.55
|
| Rate for Payer: PHP Commercial |
$739.66
|
| Rate for Payer: PHP Medicare Advantage |
$217.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$757.07
|
| Rate for Payer: Priority Health Medicare |
$219.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.65
|
| Rate for Payer: Railroad Medicare Medicare |
$217.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.77
|
| Rate for Payer: UHC Core |
$726.61
|
| Rate for Payer: UHC Exchange |
$217.55
|
| Rate for Payer: UHC Medicaid |
$153.41
|
| Rate for Payer: UHC Medicare Advantage |
$217.55
|
| Rate for Payer: UHCCP Medicaid |
$153.41
|
| Rate for Payer: VA VA |
$217.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.64
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
IP
|
$870.19
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$605.65 |
| Max. Negotiated Rate |
$783.17 |
| Rate for Payer: Aetna Commercial |
$739.66
|
| Rate for Payer: BCBS Trust/PPO |
$718.69
|
| Rate for Payer: BCN Commercial |
$718.69
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cofinity Commercial |
$748.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.15
|
| Rate for Payer: Healthscope Commercial |
$783.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.66
|
| Rate for Payer: Nomi Health Commercial |
$713.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$652.64
|
| Rate for Payer: PHP Commercial |
$739.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$757.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.77
|
| Rate for Payer: UHC Core |
$726.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.64
|
|
|
HC MULTIPLE SCLEROSIS CASCADE, S AND CSF
|
Facility
|
OP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100769
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.17 |
| Max. Negotiated Rate |
$108.07 |
| Rate for Payer: Aetna Commercial |
$102.07
|
| Rate for Payer: Aetna Medicare |
$31.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.52
|
| Rate for Payer: BCBS Complete |
$22.23
|
| Rate for Payer: BCBS MAPPO |
$30.02
|
| Rate for Payer: BCBS Trust/PPO |
$98.72
|
| Rate for Payer: BCN Commercial |
$98.72
|
| Rate for Payer: BCN Medicare Advantage |
$30.02
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$103.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.02
|
| Rate for Payer: Healthscope Commercial |
$108.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.06
|
| Rate for Payer: Mclaren Medicaid |
$21.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.52
|
| Rate for Payer: Meridian Medicaid |
$22.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.07
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.06
|
| Rate for Payer: PACE Senior Care Partners |
$28.52
|
| Rate for Payer: PACE SWMI |
$30.02
|
| Rate for Payer: PHP Commercial |
$102.07
|
| Rate for Payer: PHP Medicare Advantage |
$30.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.47
|
| Rate for Payer: Priority Health Medicare |
$30.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.58
|
| Rate for Payer: Railroad Medicare Medicare |
$30.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.67
|
| Rate for Payer: UHC Core |
$100.27
|
| Rate for Payer: UHC Exchange |
$30.02
|
| Rate for Payer: UHC Medicaid |
$21.17
|
| Rate for Payer: UHC Medicare Advantage |
$30.02
|
| Rate for Payer: UHCCP Medicaid |
$21.17
|
| Rate for Payer: VA VA |
$30.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.06
|
|
|
HC MULTIPLE SCLEROSIS CASCADE, S AND CSF
|
Facility
|
IP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100769
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$83.58 |
| Max. Negotiated Rate |
$108.07 |
| Rate for Payer: Aetna Commercial |
$102.07
|
| Rate for Payer: BCBS Trust/PPO |
$99.17
|
| Rate for Payer: BCN Commercial |
$99.17
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$103.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Healthscope Commercial |
$108.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.07
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.06
|
| Rate for Payer: PHP Commercial |
$102.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.67
|
| Rate for Payer: UHC Core |
$100.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.06
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
OP
|
$124.93
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.03 |
| Max. Negotiated Rate |
$112.44 |
| Rate for Payer: Aetna Commercial |
$106.19
|
| Rate for Payer: Aetna Medicare |
$32.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.04
|
| Rate for Payer: BCBS Complete |
$23.12
|
| Rate for Payer: BCBS MAPPO |
$31.23
|
| Rate for Payer: BCBS Trust/PPO |
$102.70
|
| Rate for Payer: BCN Commercial |
$102.70
|
| Rate for Payer: BCN Medicare Advantage |
$31.23
|
| Rate for Payer: Cash Price |
$99.94
|
| Rate for Payer: Cofinity Commercial |
$107.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.23
|
| Rate for Payer: Healthscope Commercial |
$112.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.70
|
| Rate for Payer: Mclaren Medicaid |
$22.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.79
|
| Rate for Payer: Meridian Medicaid |
$23.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.19
|
| Rate for Payer: Nomi Health Commercial |
$102.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.70
|
| Rate for Payer: PACE Senior Care Partners |
$29.67
|
| Rate for Payer: PACE SWMI |
$31.23
|
| Rate for Payer: PHP Commercial |
$106.19
|
| Rate for Payer: PHP Medicare Advantage |
$31.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.69
|
| Rate for Payer: Priority Health Medicare |
$31.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.95
|
| Rate for Payer: Railroad Medicare Medicare |
$31.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.94
|
| Rate for Payer: UHC Core |
$104.32
|
| Rate for Payer: UHC Exchange |
$31.23
|
| Rate for Payer: UHC Medicaid |
$22.03
|
| Rate for Payer: UHC Medicare Advantage |
$31.23
|
| Rate for Payer: UHCCP Medicaid |
$22.03
|
| Rate for Payer: VA VA |
$31.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.70
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
IP
|
$124.93
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$86.95 |
| Max. Negotiated Rate |
$112.44 |
| Rate for Payer: Aetna Commercial |
$106.19
|
| Rate for Payer: BCBS Trust/PPO |
$103.18
|
| Rate for Payer: BCN Commercial |
$103.18
|
| Rate for Payer: Cash Price |
$99.94
|
| Rate for Payer: Cofinity Commercial |
$107.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.94
|
| Rate for Payer: Healthscope Commercial |
$112.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.19
|
| Rate for Payer: Nomi Health Commercial |
$102.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.70
|
| Rate for Payer: PHP Commercial |
$106.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.94
|
| Rate for Payer: UHC Core |
$104.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.70
|
|
|
HC MUMPS AB IGG
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$21.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.68
|
| Rate for Payer: BCBS Complete |
$15.21
|
| Rate for Payer: BCBS MAPPO |
$20.55
|
| Rate for Payer: BCBS Trust/PPO |
$67.57
|
| Rate for Payer: BCN Commercial |
$67.57
|
| Rate for Payer: BCN Medicare Advantage |
$20.55
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.55
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.57
|
| Rate for Payer: Meridian Medicaid |
$15.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Senior Care Partners |
$19.52
|
| Rate for Payer: PACE SWMI |
$20.55
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$20.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.20
|
| Rate for Payer: Railroad Medicare Medicare |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: UHC Exchange |
$20.55
|
| Rate for Payer: UHC Medicaid |
$14.49
|
| Rate for Payer: UHC Medicare Advantage |
$20.55
|
| Rate for Payer: UHCCP Medicaid |
$14.49
|
| Rate for Payer: VA VA |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC MUMPS AB IGG
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: BCBS Trust/PPO |
$67.88
|
| Rate for Payer: BCN Commercial |
$67.88
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
OP
|
$79.07
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$71.16 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Medicare |
$20.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.71
|
| Rate for Payer: BCBS Complete |
$14.64
|
| Rate for Payer: BCBS MAPPO |
$19.77
|
| Rate for Payer: BCBS Trust/PPO |
$65.00
|
| Rate for Payer: BCN Commercial |
$65.00
|
| Rate for Payer: BCN Medicare Advantage |
$19.77
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.77
|
| Rate for Payer: Healthscope Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.30
|
| Rate for Payer: Mclaren Medicaid |
$13.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.76
|
| Rate for Payer: Meridian Medicaid |
$14.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.30
|
| Rate for Payer: PACE Senior Care Partners |
$18.78
|
| Rate for Payer: PACE SWMI |
$19.77
|
| Rate for Payer: PHP Commercial |
$67.21
|
| Rate for Payer: PHP Medicare Advantage |
$19.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.79
|
| Rate for Payer: Priority Health Medicare |
$19.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.03
|
| Rate for Payer: Railroad Medicare Medicare |
$19.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.58
|
| Rate for Payer: UHC Core |
$66.02
|
| Rate for Payer: UHC Exchange |
$19.77
|
| Rate for Payer: UHC Medicaid |
$13.94
|
| Rate for Payer: UHC Medicare Advantage |
$19.77
|
| Rate for Payer: UHCCP Medicaid |
$13.94
|
| Rate for Payer: VA VA |
$19.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.30
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
IP
|
$79.07
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.03 |
| Max. Negotiated Rate |
$71.16 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: BCBS Trust/PPO |
$65.30
|
| Rate for Payer: BCN Commercial |
$65.30
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Healthscope Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.30
|
| Rate for Payer: PHP Commercial |
$67.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.58
|
| Rate for Payer: UHC Core |
$66.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.30
|
|
|
HC MUSK AUTOANTIBODY, S
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 86366
|
| Hospital Charge Code |
30200518
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.11 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna Medicare |
$97.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.19
|
| Rate for Payer: BCBS Complete |
$69.41
|
| Rate for Payer: BCBS MAPPO |
$93.75
|
| Rate for Payer: BCBS Trust/PPO |
$308.29
|
| Rate for Payer: BCN Commercial |
$308.29
|
| Rate for Payer: BCN Medicare Advantage |
$93.75
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.75
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Mclaren Medicaid |
$66.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.44
|
| Rate for Payer: Meridian Medicaid |
$69.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.75
|
| Rate for Payer: Nomi Health Commercial |
$307.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE Senior Care Partners |
$89.06
|
| Rate for Payer: PACE SWMI |
$93.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: PHP Medicare Advantage |
$93.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.25
|
| Rate for Payer: Priority Health Medicare |
$94.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.00
|
| Rate for Payer: Railroad Medicare Medicare |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: UHC Exchange |
$93.75
|
| Rate for Payer: UHC Medicaid |
$66.11
|
| Rate for Payer: UHC Medicare Advantage |
$93.75
|
| Rate for Payer: UHCCP Medicaid |
$66.11
|
| Rate for Payer: VA VA |
$93.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC MUSK AUTOANTIBODY, S
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 86366
|
| Hospital Charge Code |
30200518
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$309.71
|
| Rate for Payer: BCN Commercial |
$309.71
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.75
|
| Rate for Payer: Nomi Health Commercial |
$307.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC MYCOBACTERIUM TUBERCULOSIS, RIFAMPIN RESISTANCE, AMP PROBE
|
Facility
|
IP
|
$119.85
|
|
|
Service Code
|
CPT 87564
|
| Hospital Charge Code |
30600345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$83.42 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Aetna Commercial |
$101.87
|
| Rate for Payer: BCBS Trust/PPO |
$98.98
|
| Rate for Payer: BCN Commercial |
$98.98
|
| Rate for Payer: Cash Price |
$95.88
|
| Rate for Payer: Cofinity Commercial |
$103.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.88
|
| Rate for Payer: Healthscope Commercial |
$107.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.87
|
| Rate for Payer: Nomi Health Commercial |
$98.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.89
|
| Rate for Payer: PHP Commercial |
$101.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.47
|
| Rate for Payer: UHC Core |
$100.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.89
|
|
|
HC MYCOBACTERIUM TUBERCULOSIS, RIFAMPIN RESISTANCE, AMP PROBE
|
Facility
|
OP
|
$119.85
|
|
|
Service Code
|
CPT 87564
|
| Hospital Charge Code |
30600345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Aetna Commercial |
$101.87
|
| Rate for Payer: Aetna Medicare |
$31.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.45
|
| Rate for Payer: BCBS Complete |
$22.18
|
| Rate for Payer: BCBS MAPPO |
$29.96
|
| Rate for Payer: BCBS Trust/PPO |
$98.53
|
| Rate for Payer: BCN Commercial |
$98.53
|
| Rate for Payer: BCN Medicare Advantage |
$29.96
|
| Rate for Payer: Cash Price |
$95.88
|
| Rate for Payer: Cofinity Commercial |
$103.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$107.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.89
|
| Rate for Payer: Mclaren Medicaid |
$21.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.46
|
| Rate for Payer: Meridian Medicaid |
$22.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.87
|
| Rate for Payer: Nomi Health Commercial |
$98.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.89
|
| Rate for Payer: PACE Senior Care Partners |
$28.46
|
| Rate for Payer: PACE SWMI |
$29.96
|
| Rate for Payer: PHP Commercial |
$101.87
|
| Rate for Payer: PHP Medicare Advantage |
$29.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.27
|
| Rate for Payer: Priority Health Medicare |
$30.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.47
|
| Rate for Payer: UHC Core |
$100.07
|
| Rate for Payer: UHC Exchange |
$29.96
|
| Rate for Payer: UHC Medicaid |
$21.13
|
| Rate for Payer: UHC Medicare Advantage |
$29.96
|
| Rate for Payer: UHCCP Medicaid |
$21.13
|
| Rate for Payer: VA VA |
$29.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.89
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
