|
HC PNEUMOCOCCAL IGG ABS 23 SEROTYPE
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200189
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.67 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: BCBS Trust/PPO |
$22.16
|
| Rate for Payer: BCN Commercial |
$22.16
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Nomi Health Commercial |
$22.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.61
|
| Rate for Payer: UHC Core |
$22.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG ABS 23 SEROTYPE
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200189
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$6.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
| Rate for Payer: BCBS Complete |
$4.97
|
| Rate for Payer: BCBS MAPPO |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$22.06
|
| Rate for Payer: BCN Commercial |
$22.06
|
| Rate for Payer: BCN Medicare Advantage |
$6.71
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.71
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Mclaren Medicaid |
$4.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.04
|
| Rate for Payer: Meridian Medicaid |
$4.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Nomi Health Commercial |
$22.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.37
|
| Rate for Payer: PACE SWMI |
$6.71
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: PHP Medicare Advantage |
$6.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.34
|
| Rate for Payer: Priority Health Medicare |
$6.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.61
|
| Rate for Payer: UHC Core |
$22.40
|
| Rate for Payer: UHC Exchange |
$6.71
|
| Rate for Payer: UHC Medicaid |
$4.73
|
| Rate for Payer: UHC Medicare Advantage |
$6.71
|
| Rate for Payer: UHCCP Medicaid |
$4.73
|
| Rate for Payer: VA VA |
$6.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG ABS PRE & POST
|
Facility
|
IP
|
$8.49
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
30200226
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$7.64 |
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: BCBS Trust/PPO |
$7.01
|
| Rate for Payer: BCN Commercial |
$7.01
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Cofinity Commercial |
$7.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.79
|
| Rate for Payer: Healthscope Commercial |
$7.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.22
|
| Rate for Payer: Nomi Health Commercial |
$6.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.37
|
| Rate for Payer: PHP Commercial |
$7.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.47
|
| Rate for Payer: UHC Core |
$7.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.37
|
|
|
HC PNEUMOCOCCAL IGG ABS PRE & POST
|
Facility
|
OP
|
$8.49
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
30200226
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$7.64 |
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: Aetna Medicare |
$2.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.65
|
| Rate for Payer: BCBS Complete |
$1.57
|
| Rate for Payer: BCBS MAPPO |
$2.12
|
| Rate for Payer: BCBS Trust/PPO |
$6.98
|
| Rate for Payer: BCN Commercial |
$6.98
|
| Rate for Payer: BCN Medicare Advantage |
$2.12
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Cofinity Commercial |
$7.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$7.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.37
|
| Rate for Payer: Mclaren Medicaid |
$1.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.23
|
| Rate for Payer: Meridian Medicaid |
$1.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.22
|
| Rate for Payer: Nomi Health Commercial |
$6.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.37
|
| Rate for Payer: PACE Senior Care Partners |
$2.02
|
| Rate for Payer: PACE SWMI |
$2.12
|
| Rate for Payer: PHP Commercial |
$7.22
|
| Rate for Payer: PHP Medicare Advantage |
$2.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.39
|
| Rate for Payer: Priority Health Medicare |
$2.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.47
|
| Rate for Payer: UHC Core |
$7.09
|
| Rate for Payer: UHC Exchange |
$2.12
|
| Rate for Payer: UHC Medicaid |
$1.50
|
| Rate for Payer: UHC Medicare Advantage |
$2.12
|
| Rate for Payer: UHCCP Medicaid |
$1.50
|
| Rate for Payer: VA VA |
$2.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.37
|
|
|
HC PNEUMOCOCCAL INJECTION
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
HCPCS G0009
|
| Hospital Charge Code |
77100010
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.78
|
| Rate for Payer: BCN Commercial |
$25.78
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC PNEUMOCOCCAL INJECTION
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
HCPCS G0009
|
| Hospital Charge Code |
77100010
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$5.78
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicaid |
$5.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$5.50
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC PNEUMOCOCCAL VACCINE
|
Facility
|
IP
|
$151.76
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
63600029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.62 |
| Max. Negotiated Rate |
$136.58 |
| Rate for Payer: Aetna Commercial |
$129.00
|
| Rate for Payer: BCBS Trust/PPO |
$125.34
|
| Rate for Payer: BCN Commercial |
$125.34
|
| Rate for Payer: Cash Price |
$121.41
|
| Rate for Payer: Cofinity Commercial |
$130.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.41
|
| Rate for Payer: Healthscope Commercial |
$136.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.00
|
| Rate for Payer: Nomi Health Commercial |
$124.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.82
|
| Rate for Payer: PHP Commercial |
$129.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.55
|
| Rate for Payer: UHC Core |
$126.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.82
|
|
|
HC PNEUMOCOCCAL VACCINE
|
Facility
|
OP
|
$151.76
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
63600029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.76 |
| Max. Negotiated Rate |
$136.58 |
| Rate for Payer: Aetna Commercial |
$129.00
|
| Rate for Payer: Aetna Medicare |
$39.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.42
|
| Rate for Payer: BCBS Complete |
$28.09
|
| Rate for Payer: BCBS MAPPO |
$37.94
|
| Rate for Payer: BCBS Trust/PPO |
$124.76
|
| Rate for Payer: BCN Commercial |
$124.76
|
| Rate for Payer: BCN Medicare Advantage |
$37.94
|
| Rate for Payer: Cash Price |
$121.41
|
| Rate for Payer: Cofinity Commercial |
$130.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.94
|
| Rate for Payer: Healthscope Commercial |
$136.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.82
|
| Rate for Payer: Mclaren Medicaid |
$26.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.84
|
| Rate for Payer: Meridian Medicaid |
$28.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.00
|
| Rate for Payer: Nomi Health Commercial |
$124.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.82
|
| Rate for Payer: PACE Senior Care Partners |
$36.04
|
| Rate for Payer: PACE SWMI |
$37.94
|
| Rate for Payer: PHP Commercial |
$129.00
|
| Rate for Payer: PHP Medicare Advantage |
$37.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.03
|
| Rate for Payer: Priority Health Medicare |
$38.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.62
|
| Rate for Payer: Railroad Medicare Medicare |
$37.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.55
|
| Rate for Payer: UHC Core |
$126.72
|
| Rate for Payer: UHC Exchange |
$37.94
|
| Rate for Payer: UHC Medicaid |
$26.76
|
| Rate for Payer: UHC Medicare Advantage |
$37.94
|
| Rate for Payer: UHCCP Medicaid |
$26.76
|
| Rate for Payer: VA VA |
$37.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.82
|
|
|
HC PNEUMOCYSTIS BY RAPID PCR
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600170
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC PNEUMOCYSTIS BY RAPID PCR
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600170
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC PNEUMONIAE AB IGM BY IFA
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.78 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$39.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.47
|
| Rate for Payer: BCBS Complete |
$28.12
|
| Rate for Payer: BCBS MAPPO |
$37.98
|
| Rate for Payer: BCBS Trust/PPO |
$124.88
|
| Rate for Payer: BCN Commercial |
$124.88
|
| Rate for Payer: BCN Medicare Advantage |
$37.98
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.98
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$26.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.87
|
| Rate for Payer: Meridian Medicaid |
$28.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Senior Care Partners |
$36.08
|
| Rate for Payer: PACE SWMI |
$37.98
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$37.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Medicare |
$38.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.72
|
| Rate for Payer: Railroad Medicare Medicare |
$37.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Medicaid |
$26.78
|
| Rate for Payer: UHC Medicare Advantage |
$37.98
|
| Rate for Payer: UHCCP Medicaid |
$26.78
|
| Rate for Payer: VA VA |
$37.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC PNEUMONIAE AB IGM BY IFA
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$105.72 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: BCBS Trust/PPO |
$125.45
|
| Rate for Payer: BCN Commercial |
$125.45
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC POC BASIC METABOLIC PANEL W/ICAL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100696
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC POC BASIC METABOLIC PANEL W/ICAL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100696
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC POC BLOOD GAS
|
Facility
|
OP
|
$168.52
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.71 |
| Max. Negotiated Rate |
$151.67 |
| Rate for Payer: Aetna Commercial |
$143.24
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: BCBS Complete |
$31.19
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCBS Trust/PPO |
$138.54
|
| Rate for Payer: BCN Commercial |
$138.54
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$134.82
|
| Rate for Payer: Cofinity Commercial |
$144.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$151.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.39
|
| Rate for Payer: Mclaren Medicaid |
$29.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$31.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.24
|
| Rate for Payer: Nomi Health Commercial |
$138.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.39
|
| Rate for Payer: PACE Senior Care Partners |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$143.24
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$146.61
|
| Rate for Payer: Priority Health Medicare |
$42.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.29
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.30
|
| Rate for Payer: UHC Core |
$140.71
|
| Rate for Payer: UHC Exchange |
$42.13
|
| Rate for Payer: UHC Medicaid |
$29.71
|
| Rate for Payer: UHC Medicare Advantage |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$29.71
|
| Rate for Payer: VA VA |
$42.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.39
|
|
|
HC POC BLOOD GAS
|
Facility
|
IP
|
$168.52
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$117.29 |
| Max. Negotiated Rate |
$151.67 |
| Rate for Payer: Aetna Commercial |
$143.24
|
| Rate for Payer: BCBS Trust/PPO |
$139.18
|
| Rate for Payer: BCN Commercial |
$139.18
|
| Rate for Payer: Cash Price |
$134.82
|
| Rate for Payer: Cofinity Commercial |
$144.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.82
|
| Rate for Payer: Healthscope Commercial |
$151.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.24
|
| Rate for Payer: Nomi Health Commercial |
$138.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.39
|
| Rate for Payer: PHP Commercial |
$143.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$146.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.30
|
| Rate for Payer: UHC Core |
$140.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.39
|
|
|
HC POC BLOOD GAS CALC O2 SAT
|
Facility
|
IP
|
$111.85
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100700
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$100.67 |
| Rate for Payer: Aetna Commercial |
$95.07
|
| Rate for Payer: BCBS Trust/PPO |
$92.38
|
| Rate for Payer: BCN Commercial |
$92.38
|
| Rate for Payer: Cash Price |
$89.48
|
| Rate for Payer: Cofinity Commercial |
$96.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.48
|
| Rate for Payer: Healthscope Commercial |
$100.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.07
|
| Rate for Payer: Nomi Health Commercial |
$91.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.89
|
| Rate for Payer: PHP Commercial |
$95.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.43
|
| Rate for Payer: UHC Core |
$93.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.89
|
|
|
HC POC BLOOD GAS CALC O2 SAT
|
Facility
|
OP
|
$111.85
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100700
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.72 |
| Max. Negotiated Rate |
$100.67 |
| Rate for Payer: Aetna Commercial |
$95.07
|
| Rate for Payer: Aetna Medicare |
$29.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.95
|
| Rate for Payer: BCBS Complete |
$20.70
|
| Rate for Payer: BCBS MAPPO |
$27.96
|
| Rate for Payer: BCBS Trust/PPO |
$91.95
|
| Rate for Payer: BCN Commercial |
$91.95
|
| Rate for Payer: BCN Medicare Advantage |
$27.96
|
| Rate for Payer: Cash Price |
$89.48
|
| Rate for Payer: Cofinity Commercial |
$96.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.96
|
| Rate for Payer: Healthscope Commercial |
$100.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.89
|
| Rate for Payer: Mclaren Medicaid |
$19.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.36
|
| Rate for Payer: Meridian Medicaid |
$20.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.07
|
| Rate for Payer: Nomi Health Commercial |
$91.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.89
|
| Rate for Payer: PACE Senior Care Partners |
$26.56
|
| Rate for Payer: PACE SWMI |
$27.96
|
| Rate for Payer: PHP Commercial |
$95.07
|
| Rate for Payer: PHP Medicare Advantage |
$27.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.31
|
| Rate for Payer: Priority Health Medicare |
$28.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.85
|
| Rate for Payer: Railroad Medicare Medicare |
$27.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.43
|
| Rate for Payer: UHC Core |
$93.39
|
| Rate for Payer: UHC Exchange |
$27.96
|
| Rate for Payer: UHC Medicaid |
$19.72
|
| Rate for Payer: UHC Medicare Advantage |
$27.96
|
| Rate for Payer: UHCCP Medicaid |
$19.72
|
| Rate for Payer: VA VA |
$27.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.89
|
|
|
HC POC CARBOXYHEMOGLOBIN QUANT
|
Facility
|
IP
|
$22.05
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$19.84 |
| Rate for Payer: Aetna Commercial |
$18.74
|
| Rate for Payer: BCBS Trust/PPO |
$18.21
|
| Rate for Payer: BCN Commercial |
$18.21
|
| Rate for Payer: Cash Price |
$17.64
|
| Rate for Payer: Cofinity Commercial |
$18.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.64
|
| Rate for Payer: Healthscope Commercial |
$19.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.74
|
| Rate for Payer: Nomi Health Commercial |
$18.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.54
|
| Rate for Payer: PHP Commercial |
$18.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.40
|
| Rate for Payer: UHC Core |
$18.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.54
|
|
|
HC POC CARBOXYHEMOGLOBIN QUANT
|
Facility
|
OP
|
$22.05
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$19.84 |
| Rate for Payer: Aetna Commercial |
$18.74
|
| Rate for Payer: Aetna Medicare |
$5.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.89
|
| Rate for Payer: BCBS Complete |
$4.08
|
| Rate for Payer: BCBS MAPPO |
$5.51
|
| Rate for Payer: BCBS Trust/PPO |
$18.13
|
| Rate for Payer: BCN Commercial |
$18.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.51
|
| Rate for Payer: Cash Price |
$17.64
|
| Rate for Payer: Cofinity Commercial |
$18.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.51
|
| Rate for Payer: Healthscope Commercial |
$19.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.54
|
| Rate for Payer: Mclaren Medicaid |
$3.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.79
|
| Rate for Payer: Meridian Medicaid |
$4.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.74
|
| Rate for Payer: Nomi Health Commercial |
$18.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.54
|
| Rate for Payer: PACE Senior Care Partners |
$5.24
|
| Rate for Payer: PACE SWMI |
$5.51
|
| Rate for Payer: PHP Commercial |
$18.74
|
| Rate for Payer: PHP Medicare Advantage |
$5.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.18
|
| Rate for Payer: Priority Health Medicare |
$5.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.40
|
| Rate for Payer: UHC Core |
$18.41
|
| Rate for Payer: UHC Exchange |
$5.51
|
| Rate for Payer: UHC Medicaid |
$3.89
|
| Rate for Payer: UHC Medicare Advantage |
$5.51
|
| Rate for Payer: UHCCP Medicaid |
$3.89
|
| Rate for Payer: VA VA |
$5.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.54
|
|
|
HC POC CHLORIDE
|
Facility
|
IP
|
$20.17
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100500
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$16.66
|
| Rate for Payer: BCN Commercial |
$16.66
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.14
|
| Rate for Payer: Healthscope Commercial |
$18.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$16.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.13
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.75
|
| Rate for Payer: UHC Core |
$16.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.13
|
|
|
HC POC CHLORIDE
|
Facility
|
OP
|
$20.17
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100500
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Medicare |
$5.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.30
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: BCBS MAPPO |
$5.04
|
| Rate for Payer: BCBS Trust/PPO |
$16.58
|
| Rate for Payer: BCN Commercial |
$16.58
|
| Rate for Payer: BCN Medicare Advantage |
$5.04
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.04
|
| Rate for Payer: Healthscope Commercial |
$18.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.13
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.29
|
| Rate for Payer: Meridian Medicaid |
$3.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$16.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.13
|
| Rate for Payer: PACE Senior Care Partners |
$4.79
|
| Rate for Payer: PACE SWMI |
$5.04
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Medicare Advantage |
$5.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.55
|
| Rate for Payer: Priority Health Medicare |
$5.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.04
|
| Rate for Payer: Railroad Medicare Medicare |
$5.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.75
|
| Rate for Payer: UHC Core |
$16.84
|
| Rate for Payer: UHC Exchange |
$5.04
|
| Rate for Payer: UHC Medicaid |
$3.56
|
| Rate for Payer: UHC Medicare Advantage |
$5.04
|
| Rate for Payer: UHCCP Medicaid |
$3.56
|
| Rate for Payer: VA VA |
$5.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.13
|
|
|
HC POC COVID ABBOTT ID NOW
|
Facility
|
IP
|
$153.88
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600328
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$107.10 |
| Max. Negotiated Rate |
$138.49 |
| Rate for Payer: Aetna Commercial |
$130.80
|
| Rate for Payer: BCBS Trust/PPO |
$127.09
|
| Rate for Payer: BCN Commercial |
$127.09
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cofinity Commercial |
$132.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.10
|
| Rate for Payer: Healthscope Commercial |
$138.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.80
|
| Rate for Payer: Nomi Health Commercial |
$126.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.41
|
| Rate for Payer: PHP Commercial |
$130.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.41
|
| Rate for Payer: UHC Core |
$128.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.41
|
|
|
HC POC COVID ABBOTT ID NOW
|
Facility
|
OP
|
$153.88
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600328
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.13 |
| Max. Negotiated Rate |
$138.49 |
| Rate for Payer: Aetna Commercial |
$130.80
|
| Rate for Payer: Aetna Medicare |
$40.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.09
|
| Rate for Payer: BCBS Complete |
$28.48
|
| Rate for Payer: BCBS MAPPO |
$38.47
|
| Rate for Payer: BCBS Trust/PPO |
$126.50
|
| Rate for Payer: BCN Commercial |
$126.50
|
| Rate for Payer: BCN Medicare Advantage |
$38.47
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cofinity Commercial |
$132.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.47
|
| Rate for Payer: Healthscope Commercial |
$138.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.41
|
| Rate for Payer: Mclaren Medicaid |
$27.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.39
|
| Rate for Payer: Meridian Medicaid |
$28.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.80
|
| Rate for Payer: Nomi Health Commercial |
$126.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.41
|
| Rate for Payer: PACE Senior Care Partners |
$36.55
|
| Rate for Payer: PACE SWMI |
$38.47
|
| Rate for Payer: PHP Commercial |
$130.80
|
| Rate for Payer: PHP Medicare Advantage |
$38.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.88
|
| Rate for Payer: Priority Health Medicare |
$38.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.10
|
| Rate for Payer: Railroad Medicare Medicare |
$38.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.41
|
| Rate for Payer: UHC Core |
$128.49
|
| Rate for Payer: UHC Exchange |
$38.47
|
| Rate for Payer: UHC Medicaid |
$27.13
|
| Rate for Payer: UHC Medicare Advantage |
$38.47
|
| Rate for Payer: UHCCP Medicaid |
$27.13
|
| Rate for Payer: VA VA |
$38.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.41
|
|
|
HC POC CREATININE SERUM
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
