|
HC SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC SALMON IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SALMON IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
OP
|
$12,425.25
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$2,951.00 |
| Max. Negotiated Rate |
$13,374.66 |
| Rate for Payer: Aetna Commercial |
$10,561.46
|
| Rate for Payer: Aetna Medicare |
$3,230.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,882.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,882.89
|
| Rate for Payer: BCBS Complete |
$13,374.66
|
| Rate for Payer: BCBS MAPPO |
$3,106.31
|
| Rate for Payer: BCBS Trust/PPO |
$9,660.63
|
| Rate for Payer: BCN Commercial |
$9,660.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,106.31
|
| Rate for Payer: Cash Price |
$9,940.20
|
| Rate for Payer: Cash Price |
$9,940.20
|
| Rate for Payer: Cofinity Commercial |
$10,685.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,940.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,106.31
|
| Rate for Payer: Healthscope Commercial |
$11,182.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,318.94
|
| Rate for Payer: Mclaren Medicaid |
$12,737.77
|
| Rate for Payer: Meridian Medicaid |
$13,374.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,261.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,572.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,561.46
|
| Rate for Payer: PACE Senior Care Partners |
$2,951.00
|
| Rate for Payer: PACE SWMI |
$3,106.31
|
| Rate for Payer: PHP Commercial |
$10,561.46
|
| Rate for Payer: PHP Medicare Advantage |
$3,106.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,737.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,697.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,809.97
|
| Rate for Payer: Priority Health Medicare |
$3,106.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,578.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,106.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,934.22
|
| Rate for Payer: UHC Core |
$10,375.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,106.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,199.50
|
| Rate for Payer: VA VA |
$3,106.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,318.94
|
|
|
HC SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
IP
|
$12,425.25
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$7,578.16 |
| Max. Negotiated Rate |
$11,182.72 |
| Rate for Payer: Aetna Commercial |
$10,561.46
|
| Rate for Payer: BCBS Trust/PPO |
$9,602.23
|
| Rate for Payer: BCN Commercial |
$9,602.23
|
| Rate for Payer: Cash Price |
$9,940.20
|
| Rate for Payer: Cofinity Commercial |
$10,685.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,940.20
|
| Rate for Payer: Healthscope Commercial |
$11,182.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,318.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,561.46
|
| Rate for Payer: PHP Commercial |
$10,561.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,697.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,809.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,578.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,934.22
|
| Rate for Payer: UHC Core |
$10,375.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,318.94
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: BCBS Trust/PPO |
$53.60
|
| Rate for Payer: BCN Commercial |
$53.60
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$18.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: BCBS Complete |
$32.65
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$53.93
|
| Rate for Payer: BCN Commercial |
$53.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$32.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PACE Senior Care Partners |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.34
|
| Rate for Payer: UHC Medicare Advantage |
$17.86
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC SARS-COV-2 COVID-19 AMP PRB
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$92.09 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Aetna Commercial |
$128.35
|
| Rate for Payer: BCBS Trust/PPO |
$116.69
|
| Rate for Payer: BCN Commercial |
$116.69
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$129.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.80
|
| Rate for Payer: Healthscope Commercial |
$135.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.35
|
| Rate for Payer: PHP Commercial |
$128.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.88
|
| Rate for Payer: UHC Core |
$126.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.25
|
|
|
HC SARS-COV-2 COVID-19 AMP PRB
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Aetna Commercial |
$128.35
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.19
|
| Rate for Payer: BCBS Complete |
$39.76
|
| Rate for Payer: BCBS MAPPO |
$37.75
|
| Rate for Payer: BCBS Trust/PPO |
$117.40
|
| Rate for Payer: BCCCP Commercial |
$25.00
|
| Rate for Payer: BCN Commercial |
$117.40
|
| Rate for Payer: BCN Medicare Advantage |
$37.75
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$129.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.75
|
| Rate for Payer: Healthscope Commercial |
$135.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.25
|
| Rate for Payer: Mclaren Medicaid |
$37.87
|
| Rate for Payer: Meridian Medicaid |
$39.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.35
|
| Rate for Payer: PACE Senior Care Partners |
$35.86
|
| Rate for Payer: PACE SWMI |
$37.75
|
| Rate for Payer: PHP Commercial |
$128.35
|
| Rate for Payer: PHP Medicare Advantage |
$37.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.37
|
| Rate for Payer: Priority Health Medicare |
$37.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.09
|
| Rate for Payer: Railroad Medicare Medicare |
$37.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.88
|
| Rate for Payer: UHC Core |
$126.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.75
|
| Rate for Payer: UHC Medicare Advantage |
$38.88
|
| Rate for Payer: VA VA |
$37.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.25
|
|
|
HC SARS-COV2/FLU A&B
|
Facility
|
IP
|
$214.20
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
30600318
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$130.64 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: BCBS Trust/PPO |
$165.53
|
| Rate for Payer: BCN Commercial |
$165.53
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.07
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.50
|
| Rate for Payer: UHC Core |
$178.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC SARS-COV2/FLU A&B
|
Facility
|
OP
|
$214.20
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
30600318
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.87 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna Medicare |
$55.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.94
|
| Rate for Payer: BCBS Complete |
$110.52
|
| Rate for Payer: BCBS MAPPO |
$53.55
|
| Rate for Payer: BCBS Trust/PPO |
$166.54
|
| Rate for Payer: BCN Commercial |
$166.54
|
| Rate for Payer: BCN Medicare Advantage |
$53.55
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.55
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Mclaren Medicaid |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$110.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.07
|
| Rate for Payer: PACE Senior Care Partners |
$50.87
|
| Rate for Payer: PACE SWMI |
$53.55
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: PHP Medicare Advantage |
$53.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.35
|
| Rate for Payer: Priority Health Medicare |
$53.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.64
|
| Rate for Payer: Railroad Medicare Medicare |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.50
|
| Rate for Payer: UHC Core |
$178.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.55
|
| Rate for Payer: UHC Medicare Advantage |
$55.16
|
| Rate for Payer: VA VA |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$110.52
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$194.30
|
| Rate for Payer: BCN Commercial |
$194.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$110.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.42
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$62.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$64.35
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$152.41 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: BCBS Trust/PPO |
$193.12
|
| Rate for Payer: BCN Commercial |
$193.12
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.42
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$214.83
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$193.35 |
| Rate for Payer: Aetna Commercial |
$182.61
|
| Rate for Payer: BCBS Trust/PPO |
$166.02
|
| Rate for Payer: BCN Commercial |
$166.02
|
| Rate for Payer: Cash Price |
$171.86
|
| Rate for Payer: Cofinity Commercial |
$184.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.86
|
| Rate for Payer: Healthscope Commercial |
$193.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.61
|
| Rate for Payer: PHP Commercial |
$182.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.05
|
| Rate for Payer: UHC Core |
$179.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.12
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$214.83
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.02 |
| Max. Negotiated Rate |
$193.35 |
| Rate for Payer: Aetna Commercial |
$182.61
|
| Rate for Payer: Aetna Medicare |
$55.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.13
|
| Rate for Payer: BCBS Complete |
$85.93
|
| Rate for Payer: BCBS MAPPO |
$53.71
|
| Rate for Payer: BCBS Trust/PPO |
$167.03
|
| Rate for Payer: BCN Commercial |
$167.03
|
| Rate for Payer: BCN Medicare Advantage |
$53.71
|
| Rate for Payer: Cash Price |
$171.86
|
| Rate for Payer: Cofinity Commercial |
$184.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.71
|
| Rate for Payer: Healthscope Commercial |
$193.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.61
|
| Rate for Payer: PACE Senior Care Partners |
$51.02
|
| Rate for Payer: PACE SWMI |
$53.71
|
| Rate for Payer: PHP Commercial |
$182.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.90
|
| Rate for Payer: Priority Health Medicare |
$53.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.02
|
| Rate for Payer: Railroad Medicare Medicare |
$53.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.05
|
| Rate for Payer: UHC Core |
$179.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.71
|
| Rate for Payer: UHC Medicare Advantage |
$55.32
|
| Rate for Payer: VA VA |
$53.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.12
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$320.85
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$195.69 |
| Max. Negotiated Rate |
$288.76 |
| Rate for Payer: Aetna Commercial |
$272.72
|
| Rate for Payer: BCBS Trust/PPO |
$247.95
|
| Rate for Payer: BCN Commercial |
$247.95
|
| Rate for Payer: Cash Price |
$256.68
|
| Rate for Payer: Cofinity Commercial |
$275.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.68
|
| Rate for Payer: Healthscope Commercial |
$288.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.72
|
| Rate for Payer: PHP Commercial |
$272.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.35
|
| Rate for Payer: UHC Core |
$267.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.64
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$320.85
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.20 |
| Max. Negotiated Rate |
$288.76 |
| Rate for Payer: Aetna Commercial |
$272.72
|
| Rate for Payer: Aetna Medicare |
$83.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.27
|
| Rate for Payer: BCBS Complete |
$128.34
|
| Rate for Payer: BCBS MAPPO |
$80.21
|
| Rate for Payer: BCBS Trust/PPO |
$249.46
|
| Rate for Payer: BCN Commercial |
$249.46
|
| Rate for Payer: BCN Medicare Advantage |
$80.21
|
| Rate for Payer: Cash Price |
$256.68
|
| Rate for Payer: Cofinity Commercial |
$275.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.21
|
| Rate for Payer: Healthscope Commercial |
$288.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.72
|
| Rate for Payer: PACE Senior Care Partners |
$76.20
|
| Rate for Payer: PACE SWMI |
$80.21
|
| Rate for Payer: PHP Commercial |
$272.72
|
| Rate for Payer: PHP Medicare Advantage |
$80.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.14
|
| Rate for Payer: Priority Health Medicare |
$80.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.69
|
| Rate for Payer: Railroad Medicare Medicare |
$80.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.35
|
| Rate for Payer: UHC Core |
$267.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.21
|
| Rate for Payer: UHC Medicare Advantage |
$82.62
|
| Rate for Payer: VA VA |
$80.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.64
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$160.44
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.10 |
| Max. Negotiated Rate |
$144.40 |
| Rate for Payer: Aetna Commercial |
$136.37
|
| Rate for Payer: Aetna Medicare |
$41.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.14
|
| Rate for Payer: BCBS Complete |
$64.18
|
| Rate for Payer: BCBS MAPPO |
$40.11
|
| Rate for Payer: BCBS Trust/PPO |
$124.74
|
| Rate for Payer: BCN Commercial |
$124.74
|
| Rate for Payer: BCN Medicare Advantage |
$40.11
|
| Rate for Payer: Cash Price |
$128.35
|
| Rate for Payer: Cofinity Commercial |
$137.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.11
|
| Rate for Payer: Healthscope Commercial |
$144.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.37
|
| Rate for Payer: PACE Senior Care Partners |
$38.10
|
| Rate for Payer: PACE SWMI |
$40.11
|
| Rate for Payer: PHP Commercial |
$136.37
|
| Rate for Payer: PHP Medicare Advantage |
$40.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.58
|
| Rate for Payer: Priority Health Medicare |
$40.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.85
|
| Rate for Payer: Railroad Medicare Medicare |
$40.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.19
|
| Rate for Payer: UHC Core |
$133.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.11
|
| Rate for Payer: UHC Medicare Advantage |
$41.31
|
| Rate for Payer: VA VA |
$40.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.33
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$160.44
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$144.40 |
| Rate for Payer: Aetna Commercial |
$136.37
|
| Rate for Payer: BCBS Trust/PPO |
$123.99
|
| Rate for Payer: BCN Commercial |
$123.99
|
| Rate for Payer: Cash Price |
$128.35
|
| Rate for Payer: Cofinity Commercial |
$137.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.35
|
| Rate for Payer: Healthscope Commercial |
$144.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.37
|
| Rate for Payer: PHP Commercial |
$136.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.19
|
| Rate for Payer: UHC Core |
$133.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.33
|
|
|
HC SARSCOV AG
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$27.38
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCCCP Commercial |
$25.00
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$26.07
|
| Rate for Payer: Meridian Medicaid |
$27.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC SARSCOV AG
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$27.38
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCCCP Commercial |
$25.00
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$26.07
|
| Rate for Payer: Meridian Medicaid |
$27.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC SARS FLU AB RSV
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$110.52
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$194.30
|
| Rate for Payer: BCN Commercial |
$194.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$110.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.42
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$62.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$64.35
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC SARS FLU AB RSV
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$152.41 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: BCBS Trust/PPO |
$193.12
|
| Rate for Payer: BCN Commercial |
$193.12
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.42
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
