|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
OP
|
$1,961.56
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$345.82 |
| Max. Negotiated Rate |
$1,765.40 |
| Rate for Payer: Aetna Commercial |
$1,667.33
|
| Rate for Payer: Aetna Medicare |
$510.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.99
|
| Rate for Payer: BCBS Complete |
$363.08
|
| Rate for Payer: BCBS MAPPO |
$490.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.60
|
| Rate for Payer: BCN Commercial |
$1,612.60
|
| Rate for Payer: BCN Medicare Advantage |
$490.39
|
| Rate for Payer: Cash Price |
$1,569.25
|
| Rate for Payer: Cofinity Commercial |
$1,686.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,569.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.39
|
| Rate for Payer: Healthscope Commercial |
$1,765.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,471.17
|
| Rate for Payer: Mclaren Medicaid |
$345.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.91
|
| Rate for Payer: Meridian Medicaid |
$363.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$539.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,667.33
|
| Rate for Payer: Nomi Health Commercial |
$1,608.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,471.17
|
| Rate for Payer: PACE Senior Care Partners |
$465.87
|
| Rate for Payer: PACE SWMI |
$490.39
|
| Rate for Payer: PHP Commercial |
$1,667.33
|
| Rate for Payer: PHP Medicare Advantage |
$490.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,706.56
|
| Rate for Payer: Priority Health Medicare |
$495.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,365.25
|
| Rate for Payer: Railroad Medicare Medicare |
$490.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,726.17
|
| Rate for Payer: UHC Core |
$1,637.90
|
| Rate for Payer: UHC Exchange |
$490.39
|
| Rate for Payer: UHC Medicaid |
$345.82
|
| Rate for Payer: UHC Medicare Advantage |
$490.39
|
| Rate for Payer: UHCCP Medicaid |
$345.82
|
| Rate for Payer: VA VA |
$490.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,471.17
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$144.49 |
| Max. Negotiated Rate |
$737.63 |
| Rate for Payer: Aetna Commercial |
$696.65
|
| Rate for Payer: Aetna Medicare |
$213.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.12
|
| Rate for Payer: BCBS Complete |
$151.71
|
| Rate for Payer: BCBS MAPPO |
$204.90
|
| Rate for Payer: BCBS Trust/PPO |
$673.78
|
| Rate for Payer: BCN Commercial |
$673.78
|
| Rate for Payer: BCN Medicare Advantage |
$204.90
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$704.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.90
|
| Rate for Payer: Healthscope Commercial |
$737.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.69
|
| Rate for Payer: Mclaren Medicaid |
$144.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.14
|
| Rate for Payer: Meridian Medicaid |
$151.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$235.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$225.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Senior Care Partners |
$194.65
|
| Rate for Payer: PACE SWMI |
$204.90
|
| Rate for Payer: PHP Commercial |
$696.65
|
| Rate for Payer: PHP Medicare Advantage |
$204.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$713.04
|
| Rate for Payer: Priority Health Medicare |
$206.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.43
|
| Rate for Payer: Railroad Medicare Medicare |
$204.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.24
|
| Rate for Payer: UHC Core |
$684.36
|
| Rate for Payer: UHC Exchange |
$204.90
|
| Rate for Payer: UHC Medicaid |
$144.49
|
| Rate for Payer: UHC Medicare Advantage |
$204.90
|
| Rate for Payer: UHCCP Medicaid |
$144.49
|
| Rate for Payer: VA VA |
$204.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.69
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$570.43 |
| Max. Negotiated Rate |
$737.63 |
| Rate for Payer: Aetna Commercial |
$696.65
|
| Rate for Payer: BCBS Trust/PPO |
$676.90
|
| Rate for Payer: BCN Commercial |
$676.90
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$704.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$737.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PHP Commercial |
$696.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$713.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.24
|
| Rate for Payer: UHC Core |
$684.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.69
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$144.49 |
| Max. Negotiated Rate |
$737.63 |
| Rate for Payer: Aetna Commercial |
$696.65
|
| Rate for Payer: Aetna Medicare |
$213.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.12
|
| Rate for Payer: BCBS Complete |
$151.71
|
| Rate for Payer: BCBS MAPPO |
$204.90
|
| Rate for Payer: BCBS Trust/PPO |
$673.78
|
| Rate for Payer: BCN Commercial |
$673.78
|
| Rate for Payer: BCN Medicare Advantage |
$204.90
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$704.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.90
|
| Rate for Payer: Healthscope Commercial |
$737.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.69
|
| Rate for Payer: Mclaren Medicaid |
$144.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.14
|
| Rate for Payer: Meridian Medicaid |
$151.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$235.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$225.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Senior Care Partners |
$194.65
|
| Rate for Payer: PACE SWMI |
$204.90
|
| Rate for Payer: PHP Commercial |
$696.65
|
| Rate for Payer: PHP Medicare Advantage |
$204.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$713.04
|
| Rate for Payer: Priority Health Medicare |
$206.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.43
|
| Rate for Payer: Railroad Medicare Medicare |
$204.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.24
|
| Rate for Payer: UHC Core |
$684.36
|
| Rate for Payer: UHC Exchange |
$204.90
|
| Rate for Payer: UHC Medicaid |
$144.49
|
| Rate for Payer: UHC Medicare Advantage |
$204.90
|
| Rate for Payer: UHCCP Medicaid |
$144.49
|
| Rate for Payer: VA VA |
$204.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.69
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$570.43 |
| Max. Negotiated Rate |
$737.63 |
| Rate for Payer: Aetna Commercial |
$696.65
|
| Rate for Payer: BCBS Trust/PPO |
$676.90
|
| Rate for Payer: BCN Commercial |
$676.90
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$704.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$737.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PHP Commercial |
$696.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$713.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.24
|
| Rate for Payer: UHC Core |
$684.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.69
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$570.43 |
| Max. Negotiated Rate |
$737.63 |
| Rate for Payer: Aetna Commercial |
$696.65
|
| Rate for Payer: BCBS Trust/PPO |
$676.90
|
| Rate for Payer: BCN Commercial |
$676.90
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$704.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$737.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PHP Commercial |
$696.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$713.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.24
|
| Rate for Payer: UHC Core |
$684.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.69
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$144.49 |
| Max. Negotiated Rate |
$737.63 |
| Rate for Payer: Aetna Commercial |
$696.65
|
| Rate for Payer: Aetna Medicare |
$213.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.12
|
| Rate for Payer: BCBS Complete |
$151.71
|
| Rate for Payer: BCBS MAPPO |
$204.90
|
| Rate for Payer: BCBS Trust/PPO |
$673.78
|
| Rate for Payer: BCN Commercial |
$673.78
|
| Rate for Payer: BCN Medicare Advantage |
$204.90
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$704.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.90
|
| Rate for Payer: Healthscope Commercial |
$737.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.69
|
| Rate for Payer: Mclaren Medicaid |
$144.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.14
|
| Rate for Payer: Meridian Medicaid |
$151.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$235.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$225.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Senior Care Partners |
$194.65
|
| Rate for Payer: PACE SWMI |
$204.90
|
| Rate for Payer: PHP Commercial |
$696.65
|
| Rate for Payer: PHP Medicare Advantage |
$204.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$713.04
|
| Rate for Payer: Priority Health Medicare |
$206.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.43
|
| Rate for Payer: Railroad Medicare Medicare |
$204.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.24
|
| Rate for Payer: UHC Core |
$684.36
|
| Rate for Payer: UHC Exchange |
$204.90
|
| Rate for Payer: UHC Medicaid |
$144.49
|
| Rate for Payer: UHC Medicare Advantage |
$204.90
|
| Rate for Payer: UHCCP Medicaid |
$144.49
|
| Rate for Payer: VA VA |
$204.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.69
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
OP
|
$221.61
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$39.07 |
| Max. Negotiated Rate |
$199.45 |
| Rate for Payer: Aetna Commercial |
$188.37
|
| Rate for Payer: Aetna Medicare |
$57.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.25
|
| Rate for Payer: BCBS Complete |
$41.02
|
| Rate for Payer: BCBS MAPPO |
$55.40
|
| Rate for Payer: BCBS Trust/PPO |
$182.19
|
| Rate for Payer: BCN Commercial |
$182.19
|
| Rate for Payer: BCN Medicare Advantage |
$55.40
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$190.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.40
|
| Rate for Payer: Healthscope Commercial |
$199.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.21
|
| Rate for Payer: Mclaren Medicaid |
$39.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.17
|
| Rate for Payer: Meridian Medicaid |
$41.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.21
|
| Rate for Payer: PACE Senior Care Partners |
$52.63
|
| Rate for Payer: PACE SWMI |
$55.40
|
| Rate for Payer: PHP Commercial |
$188.37
|
| Rate for Payer: PHP Medicare Advantage |
$55.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.80
|
| Rate for Payer: Priority Health Medicare |
$55.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.24
|
| Rate for Payer: Railroad Medicare Medicare |
$55.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.02
|
| Rate for Payer: UHC Core |
$185.04
|
| Rate for Payer: UHC Exchange |
$55.40
|
| Rate for Payer: UHC Medicaid |
$39.07
|
| Rate for Payer: UHC Medicare Advantage |
$55.40
|
| Rate for Payer: UHCCP Medicaid |
$39.07
|
| Rate for Payer: VA VA |
$55.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.21
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
IP
|
$221.61
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$154.24 |
| Max. Negotiated Rate |
$199.45 |
| Rate for Payer: Aetna Commercial |
$188.37
|
| Rate for Payer: BCBS Trust/PPO |
$183.03
|
| Rate for Payer: BCN Commercial |
$183.03
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$190.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Healthscope Commercial |
$199.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.21
|
| Rate for Payer: PHP Commercial |
$188.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.02
|
| Rate for Payer: UHC Core |
$185.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.21
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
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 RAGWEED SHORT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
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 RAJI CELL ASSAY
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$107.17 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: BCBS Trust/PPO |
$127.17
|
| Rate for Payer: BCN Commercial |
$127.17
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna Medicare |
$40.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: BCBS Complete |
$28.50
|
| Rate for Payer: BCBS MAPPO |
$38.49
|
| Rate for Payer: BCBS Trust/PPO |
$126.59
|
| Rate for Payer: BCN Commercial |
$126.59
|
| Rate for Payer: BCN Medicare Advantage |
$38.49
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.49
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Mclaren Medicaid |
$27.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: Meridian Medicaid |
$28.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: PACE Senior Care Partners |
$36.57
|
| Rate for Payer: PACE SWMI |
$38.49
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: PHP Medicare Advantage |
$38.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Medicare |
$38.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.17
|
| Rate for Payer: Railroad Medicare Medicare |
$38.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: UHC Exchange |
$38.49
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHC Medicare Advantage |
$38.49
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$38.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
OP
|
$551.57
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.24 |
| Max. Negotiated Rate |
$496.41 |
| Rate for Payer: Aetna Commercial |
$468.83
|
| Rate for Payer: Aetna Medicare |
$143.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.37
|
| Rate for Payer: BCBS Complete |
$102.10
|
| Rate for Payer: BCBS MAPPO |
$137.89
|
| Rate for Payer: BCBS Trust/PPO |
$453.45
|
| Rate for Payer: BCN Commercial |
$453.45
|
| Rate for Payer: BCN Medicare Advantage |
$137.89
|
| Rate for Payer: Cash Price |
$441.26
|
| Rate for Payer: Cofinity Commercial |
$474.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.89
|
| Rate for Payer: Healthscope Commercial |
$496.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.68
|
| Rate for Payer: Mclaren Medicaid |
$97.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.79
|
| Rate for Payer: Meridian Medicaid |
$102.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$468.83
|
| Rate for Payer: Nomi Health Commercial |
$452.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$413.68
|
| Rate for Payer: PACE Senior Care Partners |
$131.00
|
| Rate for Payer: PACE SWMI |
$137.89
|
| Rate for Payer: PHP Commercial |
$468.83
|
| Rate for Payer: PHP Medicare Advantage |
$137.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$479.87
|
| Rate for Payer: Priority Health Medicare |
$139.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$383.89
|
| Rate for Payer: Railroad Medicare Medicare |
$137.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.38
|
| Rate for Payer: UHC Core |
$460.56
|
| Rate for Payer: UHC Exchange |
$137.89
|
| Rate for Payer: UHC Medicaid |
$97.24
|
| Rate for Payer: UHC Medicare Advantage |
$137.89
|
| Rate for Payer: UHCCP Medicaid |
$97.24
|
| Rate for Payer: VA VA |
$137.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.68
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
IP
|
$551.57
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$383.89 |
| Max. Negotiated Rate |
$496.41 |
| Rate for Payer: Aetna Commercial |
$468.83
|
| Rate for Payer: BCBS Trust/PPO |
$455.54
|
| Rate for Payer: BCN Commercial |
$455.54
|
| Rate for Payer: Cash Price |
$441.26
|
| Rate for Payer: Cofinity Commercial |
$474.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.26
|
| Rate for Payer: Healthscope Commercial |
$496.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$468.83
|
| Rate for Payer: Nomi Health Commercial |
$452.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$413.68
|
| Rate for Payer: PHP Commercial |
$468.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$479.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$383.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.38
|
| Rate for Payer: UHC Core |
$460.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.68
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
IP
|
$156.78
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$109.12 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: Aetna Commercial |
$133.26
|
| Rate for Payer: BCBS Trust/PPO |
$129.48
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: Cash Price |
$125.42
|
| Rate for Payer: Cofinity Commercial |
$134.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.42
|
| Rate for Payer: Healthscope Commercial |
$141.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.26
|
| Rate for Payer: Nomi Health Commercial |
$128.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.58
|
| Rate for Payer: PHP Commercial |
$133.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.97
|
| Rate for Payer: UHC Core |
$130.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.58
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
OP
|
$156.78
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: Aetna Commercial |
$133.26
|
| Rate for Payer: Aetna Medicare |
$40.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.99
|
| Rate for Payer: BCBS Complete |
$29.02
|
| Rate for Payer: BCBS MAPPO |
$39.20
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: BCN Medicare Advantage |
$39.20
|
| Rate for Payer: Cash Price |
$125.42
|
| Rate for Payer: Cofinity Commercial |
$134.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.20
|
| Rate for Payer: Healthscope Commercial |
$141.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.58
|
| Rate for Payer: Mclaren Medicaid |
$27.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.15
|
| Rate for Payer: Meridian Medicaid |
$29.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.26
|
| Rate for Payer: Nomi Health Commercial |
$128.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.58
|
| Rate for Payer: PACE Senior Care Partners |
$37.24
|
| Rate for Payer: PACE SWMI |
$39.20
|
| Rate for Payer: PHP Commercial |
$133.26
|
| Rate for Payer: PHP Medicare Advantage |
$39.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.40
|
| Rate for Payer: Priority Health Medicare |
$39.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.12
|
| Rate for Payer: Railroad Medicare Medicare |
$39.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.97
|
| Rate for Payer: UHC Core |
$130.91
|
| Rate for Payer: UHC Exchange |
$39.20
|
| Rate for Payer: UHC Medicaid |
$27.64
|
| Rate for Payer: UHC Medicare Advantage |
$39.20
|
| Rate for Payer: UHCCP Medicaid |
$27.64
|
| Rate for Payer: VA VA |
$39.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.58
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
OP
|
$79.49
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$71.54 |
| Rate for Payer: Aetna Commercial |
$67.57
|
| Rate for Payer: Aetna Medicare |
$20.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.84
|
| Rate for Payer: BCBS Complete |
$14.71
|
| Rate for Payer: BCBS MAPPO |
$19.87
|
| Rate for Payer: BCBS Trust/PPO |
$65.35
|
| Rate for Payer: BCN Commercial |
$65.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.87
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cofinity Commercial |
$68.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$71.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.62
|
| Rate for Payer: Mclaren Medicaid |
$14.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.87
|
| Rate for Payer: Meridian Medicaid |
$14.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.57
|
| Rate for Payer: Nomi Health Commercial |
$65.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.62
|
| Rate for Payer: PACE Senior Care Partners |
$18.88
|
| Rate for Payer: PACE SWMI |
$19.87
|
| Rate for Payer: PHP Commercial |
$67.57
|
| Rate for Payer: PHP Medicare Advantage |
$19.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.16
|
| Rate for Payer: Priority Health Medicare |
$20.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.33
|
| Rate for Payer: Railroad Medicare Medicare |
$19.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.95
|
| Rate for Payer: UHC Core |
$66.37
|
| Rate for Payer: UHC Exchange |
$19.87
|
| Rate for Payer: UHC Medicaid |
$14.01
|
| Rate for Payer: UHC Medicare Advantage |
$19.87
|
| Rate for Payer: UHCCP Medicaid |
$14.01
|
| Rate for Payer: VA VA |
$19.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.62
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
IP
|
$79.49
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.33 |
| Max. Negotiated Rate |
$71.54 |
| Rate for Payer: Aetna Commercial |
$67.57
|
| Rate for Payer: BCBS Trust/PPO |
$65.65
|
| Rate for Payer: BCN Commercial |
$65.65
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cofinity Commercial |
$68.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.59
|
| Rate for Payer: Healthscope Commercial |
$71.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.57
|
| Rate for Payer: Nomi Health Commercial |
$65.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.62
|
| Rate for Payer: PHP Commercial |
$67.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.95
|
| Rate for Payer: UHC Core |
$66.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.62
|
|
|
HC RAPID INFUSER
|
Facility
|
IP
|
$1,461.10
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,016.93 |
| Max. Negotiated Rate |
$1,314.99 |
| Rate for Payer: Aetna Commercial |
$1,241.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.72
|
| Rate for Payer: BCN Commercial |
$1,206.72
|
| Rate for Payer: Cash Price |
$1,168.88
|
| Rate for Payer: Cofinity Commercial |
$1,256.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,168.88
|
| Rate for Payer: Healthscope Commercial |
$1,314.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,095.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.93
|
| Rate for Payer: Nomi Health Commercial |
$1,198.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.83
|
| Rate for Payer: PHP Commercial |
$1,241.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,271.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,016.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.77
|
| Rate for Payer: UHC Core |
$1,220.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,095.83
|
|
|
HC RAPID INFUSER
|
Facility
|
OP
|
$1,461.10
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$257.59 |
| Max. Negotiated Rate |
$1,314.99 |
| Rate for Payer: Aetna Commercial |
$1,241.93
|
| Rate for Payer: Aetna Medicare |
$379.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$456.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$456.59
|
| Rate for Payer: BCBS Complete |
$270.45
|
| Rate for Payer: BCBS MAPPO |
$365.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.17
|
| Rate for Payer: BCN Commercial |
$1,201.17
|
| Rate for Payer: BCN Medicare Advantage |
$365.27
|
| Rate for Payer: Cash Price |
$1,168.88
|
| Rate for Payer: Cofinity Commercial |
$1,256.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,168.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.27
|
| Rate for Payer: Healthscope Commercial |
$1,314.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,095.83
|
| Rate for Payer: Mclaren Medicaid |
$257.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$383.54
|
| Rate for Payer: Meridian Medicaid |
$270.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$420.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$401.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.93
|
| Rate for Payer: Nomi Health Commercial |
$1,198.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.83
|
| Rate for Payer: PACE Senior Care Partners |
$347.01
|
| Rate for Payer: PACE SWMI |
$365.27
|
| Rate for Payer: PHP Commercial |
$1,241.93
|
| Rate for Payer: PHP Medicare Advantage |
$365.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,271.16
|
| Rate for Payer: Priority Health Medicare |
$368.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,016.93
|
| Rate for Payer: Railroad Medicare Medicare |
$365.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.77
|
| Rate for Payer: UHC Core |
$1,220.02
|
| Rate for Payer: UHC Exchange |
$365.27
|
| Rate for Payer: UHC Medicaid |
$257.59
|
| Rate for Payer: UHC Medicare Advantage |
$365.27
|
| Rate for Payer: UHCCP Medicaid |
$257.59
|
| Rate for Payer: VA VA |
$365.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,095.83
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| 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 RAPID MALARIA ASSAY
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| 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 RAPID STREP SCREEN.
|
Facility
|
IP
|
$62.93
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$56.64 |
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: BCBS Trust/PPO |
$51.97
|
| Rate for Payer: BCN Commercial |
$51.97
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.20
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.38
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.20
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
OP
|
$62.93
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.09 |
| Max. Negotiated Rate |
$56.64 |
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Medicare |
$16.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.67
|
| Rate for Payer: BCBS Complete |
$11.65
|
| Rate for Payer: BCBS MAPPO |
$15.73
|
| Rate for Payer: BCBS Trust/PPO |
$51.73
|
| Rate for Payer: BCN Commercial |
$51.73
|
| Rate for Payer: BCN Medicare Advantage |
$15.73
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.73
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.20
|
| Rate for Payer: Mclaren Medicaid |
$11.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.52
|
| Rate for Payer: Meridian Medicaid |
$11.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.20
|
| Rate for Payer: PACE Senior Care Partners |
$14.95
|
| Rate for Payer: PACE SWMI |
$15.73
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Medicare Advantage |
$15.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.75
|
| Rate for Payer: Priority Health Medicare |
$15.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.38
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: UHC Exchange |
$15.73
|
| Rate for Payer: UHC Medicaid |
$11.09
|
| Rate for Payer: UHC Medicare Advantage |
$15.73
|
| Rate for Payer: UHCCP Medicaid |
$11.09
|
| Rate for Payer: VA VA |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.20
|
|
