|
HC RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Facility
|
IP
|
$15,687.60
|
|
|
Service Code
|
CPT 35266
|
| Hospital Charge Code |
36000124
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,918.57 |
| Max. Negotiated Rate |
$14,118.84 |
| Rate for Payer: Aetna Commercial |
$13,334.46
|
| Rate for Payer: BCBS Trust/PPO |
$12,956.39
|
| Rate for Payer: BCN Commercial |
$12,956.39
|
| Rate for Payer: Cash Price |
$12,550.08
|
| Rate for Payer: Cofinity Commercial |
$13,491.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,550.08
|
| Rate for Payer: Healthscope Commercial |
$14,118.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,765.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,334.46
|
| Rate for Payer: Nomi Health Commercial |
$12,863.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,765.70
|
| Rate for Payer: PHP Commercial |
$13,334.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,648.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,918.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,805.09
|
| Rate for Payer: UHC Core |
$13,099.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,765.70
|
|
|
HC RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Facility
|
OP
|
$15,687.60
|
|
|
Service Code
|
CPT 35266
|
| Hospital Charge Code |
36000124
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,765.72 |
| Max. Negotiated Rate |
$14,118.84 |
| Rate for Payer: Aetna Commercial |
$13,334.46
|
| Rate for Payer: Aetna Medicare |
$4,078.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,902.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,902.38
|
| Rate for Payer: BCBS Complete |
$2,903.77
|
| Rate for Payer: BCBS MAPPO |
$3,921.90
|
| Rate for Payer: BCBS Trust/PPO |
$12,896.78
|
| Rate for Payer: BCN Commercial |
$12,896.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,921.90
|
| Rate for Payer: Cash Price |
$12,550.08
|
| Rate for Payer: Cofinity Commercial |
$13,491.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,550.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,921.90
|
| Rate for Payer: Healthscope Commercial |
$14,118.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,765.70
|
| Rate for Payer: Mclaren Medicaid |
$2,765.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,117.99
|
| Rate for Payer: Meridian Medicaid |
$2,903.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,510.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,314.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,334.46
|
| Rate for Payer: Nomi Health Commercial |
$12,863.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,765.70
|
| Rate for Payer: PACE Senior Care Partners |
$3,725.80
|
| Rate for Payer: PACE SWMI |
$3,921.90
|
| Rate for Payer: PHP Commercial |
$13,334.46
|
| Rate for Payer: PHP Medicare Advantage |
$3,921.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,765.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,648.21
|
| Rate for Payer: Priority Health Medicare |
$3,961.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,918.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,921.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,805.09
|
| Rate for Payer: UHC Core |
$13,099.15
|
| Rate for Payer: UHC Exchange |
$3,921.90
|
| Rate for Payer: UHC Medicaid |
$2,765.72
|
| Rate for Payer: UHC Medicare Advantage |
$3,921.90
|
| Rate for Payer: UHCCP Medicaid |
$2,765.72
|
| Rate for Payer: VA VA |
$3,921.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,765.70
|
|
|
HC RPR (SYPHILIS SEROLOGY) SERUM
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200213
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC RPR (SYPHILIS SEROLOGY) SERUM
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200213
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC RPR TITER
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200425
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC RPR TITER
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200425
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC RSV DNA/RNA AMP PROBE
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
30600315
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$65.73
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC RSV DNA/RNA AMP PROBE
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
30600315
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.87
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$19.90
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.89
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.90
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Medicare |
$20.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: UHC Exchange |
$19.90
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 0.5ML IM
|
Facility
|
OP
|
$1,328.59
|
|
|
Service Code
|
CPT 90380
|
| Hospital Charge Code |
63600232
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$234.23 |
| Max. Negotiated Rate |
$1,195.73 |
| Rate for Payer: Aetna Commercial |
$1,129.30
|
| Rate for Payer: Aetna Medicare |
$345.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$415.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$415.18
|
| Rate for Payer: BCBS Complete |
$245.92
|
| Rate for Payer: BCBS MAPPO |
$332.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.23
|
| Rate for Payer: BCN Commercial |
$1,092.23
|
| Rate for Payer: BCN Medicare Advantage |
$332.15
|
| Rate for Payer: Cash Price |
$1,062.87
|
| Rate for Payer: Cofinity Commercial |
$1,142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,062.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.15
|
| Rate for Payer: Healthscope Commercial |
$1,195.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$996.44
|
| Rate for Payer: Mclaren Medicaid |
$234.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.75
|
| Rate for Payer: Meridian Medicaid |
$245.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$381.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,129.30
|
| Rate for Payer: Nomi Health Commercial |
$1,089.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$996.44
|
| Rate for Payer: PACE Senior Care Partners |
$315.54
|
| Rate for Payer: PACE SWMI |
$332.15
|
| Rate for Payer: PHP Commercial |
$1,129.30
|
| Rate for Payer: PHP Medicare Advantage |
$332.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,155.87
|
| Rate for Payer: Priority Health Medicare |
$335.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.70
|
| Rate for Payer: Railroad Medicare Medicare |
$332.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.16
|
| Rate for Payer: UHC Core |
$1,109.37
|
| Rate for Payer: UHC Exchange |
$332.15
|
| Rate for Payer: UHC Medicaid |
$234.23
|
| Rate for Payer: UHC Medicare Advantage |
$332.15
|
| Rate for Payer: UHCCP Medicaid |
$234.23
|
| Rate for Payer: VA VA |
$332.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$996.44
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 0.5ML IM
|
Facility
|
IP
|
$1,328.59
|
|
|
Service Code
|
CPT 90380
|
| Hospital Charge Code |
63600232
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$924.70 |
| Max. Negotiated Rate |
$1,195.73 |
| Rate for Payer: Aetna Commercial |
$1,129.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,097.28
|
| Rate for Payer: BCN Commercial |
$1,097.28
|
| Rate for Payer: Cash Price |
$1,062.87
|
| Rate for Payer: Cofinity Commercial |
$1,142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,062.87
|
| Rate for Payer: Healthscope Commercial |
$1,195.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$996.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,129.30
|
| Rate for Payer: Nomi Health Commercial |
$1,089.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$996.44
|
| Rate for Payer: PHP Commercial |
$1,129.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,155.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.16
|
| Rate for Payer: UHC Core |
$1,109.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$996.44
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 1 ML IM
|
Facility
|
OP
|
$1,328.59
|
|
|
Service Code
|
CPT 90381
|
| Hospital Charge Code |
63600233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$234.23 |
| Max. Negotiated Rate |
$1,195.73 |
| Rate for Payer: Aetna Commercial |
$1,129.30
|
| Rate for Payer: Aetna Medicare |
$345.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$415.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$415.18
|
| Rate for Payer: BCBS Complete |
$245.92
|
| Rate for Payer: BCBS MAPPO |
$332.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.23
|
| Rate for Payer: BCN Commercial |
$1,092.23
|
| Rate for Payer: BCN Medicare Advantage |
$332.15
|
| Rate for Payer: Cash Price |
$1,062.87
|
| Rate for Payer: Cofinity Commercial |
$1,142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,062.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.15
|
| Rate for Payer: Healthscope Commercial |
$1,195.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$996.44
|
| Rate for Payer: Mclaren Medicaid |
$234.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.75
|
| Rate for Payer: Meridian Medicaid |
$245.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$381.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,129.30
|
| Rate for Payer: Nomi Health Commercial |
$1,089.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$996.44
|
| Rate for Payer: PACE Senior Care Partners |
$315.54
|
| Rate for Payer: PACE SWMI |
$332.15
|
| Rate for Payer: PHP Commercial |
$1,129.30
|
| Rate for Payer: PHP Medicare Advantage |
$332.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,155.87
|
| Rate for Payer: Priority Health Medicare |
$335.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.70
|
| Rate for Payer: Railroad Medicare Medicare |
$332.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.16
|
| Rate for Payer: UHC Core |
$1,109.37
|
| Rate for Payer: UHC Exchange |
$332.15
|
| Rate for Payer: UHC Medicaid |
$234.23
|
| Rate for Payer: UHC Medicare Advantage |
$332.15
|
| Rate for Payer: UHCCP Medicaid |
$234.23
|
| Rate for Payer: VA VA |
$332.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$996.44
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 1 ML IM
|
Facility
|
IP
|
$1,328.59
|
|
|
Service Code
|
CPT 90381
|
| Hospital Charge Code |
63600233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$924.70 |
| Max. Negotiated Rate |
$1,195.73 |
| Rate for Payer: Aetna Commercial |
$1,129.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,097.28
|
| Rate for Payer: BCN Commercial |
$1,097.28
|
| Rate for Payer: Cash Price |
$1,062.87
|
| Rate for Payer: Cofinity Commercial |
$1,142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,062.87
|
| Rate for Payer: Healthscope Commercial |
$1,195.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$996.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,129.30
|
| Rate for Payer: Nomi Health Commercial |
$1,089.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$996.44
|
| Rate for Payer: PHP Commercial |
$1,129.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,155.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.16
|
| Rate for Payer: UHC Core |
$1,109.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$996.44
|
|
|
HC RT ANGLE BALL COR CANN
|
Facility
|
OP
|
$72.10
|
|
| Hospital Charge Code |
27000268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.71 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: Aetna Medicare |
$18.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.53
|
| Rate for Payer: BCBS Complete |
$13.35
|
| Rate for Payer: BCBS MAPPO |
$18.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.27
|
| Rate for Payer: BCN Commercial |
$59.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.02
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.02
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Mclaren Medicaid |
$12.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.93
|
| Rate for Payer: Meridian Medicaid |
$13.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.08
|
| Rate for Payer: PACE Senior Care Partners |
$17.12
|
| Rate for Payer: PACE SWMI |
$18.02
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: PHP Medicare Advantage |
$18.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.73
|
| Rate for Payer: Priority Health Medicare |
$18.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.45
|
| Rate for Payer: UHC Core |
$60.20
|
| Rate for Payer: UHC Exchange |
$18.02
|
| Rate for Payer: UHC Medicaid |
$12.71
|
| Rate for Payer: UHC Medicare Advantage |
$18.02
|
| Rate for Payer: UHCCP Medicaid |
$12.71
|
| Rate for Payer: VA VA |
$18.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
|
HC RT ANGLE BALL COR CANN
|
Facility
|
IP
|
$72.10
|
|
| Hospital Charge Code |
27000268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.18 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$59.55
|
| Rate for Payer: BCN Commercial |
$59.55
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.08
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.45
|
| Rate for Payer: UHC Core |
$60.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
|
HC RUBELLA ANTIBODY IGC
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC RUBELLA ANTIBODY IGC
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
OP
|
$89.58
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: Aetna Medicare |
$23.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.99
|
| Rate for Payer: BCBS Complete |
$16.58
|
| Rate for Payer: BCBS MAPPO |
$22.39
|
| Rate for Payer: BCBS Trust/PPO |
$73.64
|
| Rate for Payer: BCN Commercial |
$73.64
|
| Rate for Payer: BCN Medicare Advantage |
$22.39
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.39
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Mclaren Medicaid |
$15.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.51
|
| Rate for Payer: Meridian Medicaid |
$16.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PACE Senior Care Partners |
$21.28
|
| Rate for Payer: PACE SWMI |
$22.39
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: PHP Medicare Advantage |
$22.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.93
|
| Rate for Payer: Priority Health Medicare |
$22.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$74.80
|
| Rate for Payer: UHC Exchange |
$22.39
|
| Rate for Payer: UHC Medicaid |
$15.79
|
| Rate for Payer: UHC Medicare Advantage |
$22.39
|
| Rate for Payer: UHCCP Medicaid |
$15.79
|
| Rate for Payer: VA VA |
$22.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
IP
|
$89.58
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.35 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: BCBS Trust/PPO |
$73.98
|
| Rate for Payer: BCN Commercial |
$73.98
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$74.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
OP
|
$2,091.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$368.64 |
| Max. Negotiated Rate |
$1,881.90 |
| Rate for Payer: Aetna Commercial |
$1,777.35
|
| Rate for Payer: Aetna Medicare |
$543.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$653.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$653.44
|
| Rate for Payer: BCBS Complete |
$387.04
|
| Rate for Payer: BCBS MAPPO |
$522.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,719.01
|
| Rate for Payer: BCN Commercial |
$1,719.01
|
| Rate for Payer: BCN Medicare Advantage |
$522.75
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cofinity Commercial |
$1,798.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.75
|
| Rate for Payer: Healthscope Commercial |
$1,881.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.25
|
| Rate for Payer: Mclaren Medicaid |
$368.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.89
|
| Rate for Payer: Meridian Medicaid |
$387.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$601.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$575.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.35
|
| Rate for Payer: Nomi Health Commercial |
$1,714.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.25
|
| Rate for Payer: PACE Senior Care Partners |
$496.61
|
| Rate for Payer: PACE SWMI |
$522.75
|
| Rate for Payer: PHP Commercial |
$1,777.35
|
| Rate for Payer: PHP Medicare Advantage |
$522.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,819.17
|
| Rate for Payer: Priority Health Medicare |
$527.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,455.34
|
| Rate for Payer: Railroad Medicare Medicare |
$522.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,840.08
|
| Rate for Payer: UHC Core |
$1,745.98
|
| Rate for Payer: UHC Exchange |
$522.75
|
| Rate for Payer: UHC Medicaid |
$368.64
|
| Rate for Payer: UHC Medicare Advantage |
$522.75
|
| Rate for Payer: UHCCP Medicaid |
$368.64
|
| Rate for Payer: VA VA |
$522.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.25
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
IP
|
$2,091.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,455.34 |
| Max. Negotiated Rate |
$1,881.90 |
| Rate for Payer: Aetna Commercial |
$1,777.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,726.96
|
| Rate for Payer: BCN Commercial |
$1,726.96
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cofinity Commercial |
$1,798.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.80
|
| Rate for Payer: Healthscope Commercial |
$1,881.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.35
|
| Rate for Payer: Nomi Health Commercial |
$1,714.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.25
|
| Rate for Payer: PHP Commercial |
$1,777.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,819.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,455.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,840.08
|
| Rate for Payer: UHC Core |
$1,745.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.25
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
IP
|
$62.84
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.74 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: BCBS Trust/PPO |
$51.90
|
| Rate for Payer: BCN Commercial |
$51.90
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.30
|
| Rate for Payer: UHC Core |
$52.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.13
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
OP
|
$62.84
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna Medicare |
$16.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.64
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.66
|
| Rate for Payer: BCN Commercial |
$51.66
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.13
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.50
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.67
|
| Rate for Payer: Priority Health Medicare |
$15.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.74
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.30
|
| Rate for Payer: UHC Core |
$52.47
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.13
|
|
|
HC RUSSIAN THISTLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
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
|
|
