|
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
|
|
|
HC SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
IP
|
$1,379.57
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$960.18 |
| Max. Negotiated Rate |
$1,241.61 |
| Rate for Payer: Aetna Commercial |
$1,172.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,139.39
|
| Rate for Payer: BCN Commercial |
$1,139.39
|
| Rate for Payer: Cash Price |
$1,103.66
|
| Rate for Payer: Cofinity Commercial |
$1,186.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.66
|
| Rate for Payer: Healthscope Commercial |
$1,241.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,034.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,172.63
|
| Rate for Payer: Nomi Health Commercial |
$1,131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,034.68
|
| Rate for Payer: PHP Commercial |
$1,172.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,200.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$960.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.02
|
| Rate for Payer: UHC Core |
$1,151.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,034.68
|
|
|
HC SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
OP
|
$1,379.57
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$243.22 |
| Max. Negotiated Rate |
$1,241.61 |
| Rate for Payer: Aetna Commercial |
$1,172.63
|
| Rate for Payer: Aetna Medicare |
$358.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.12
|
| Rate for Payer: BCBS Complete |
$255.36
|
| Rate for Payer: BCBS MAPPO |
$344.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.14
|
| Rate for Payer: BCN Commercial |
$1,134.14
|
| Rate for Payer: BCN Medicare Advantage |
$344.89
|
| Rate for Payer: Cash Price |
$1,103.66
|
| Rate for Payer: Cofinity Commercial |
$1,186.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.89
|
| Rate for Payer: Healthscope Commercial |
$1,241.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,034.68
|
| Rate for Payer: Mclaren Medicaid |
$243.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.14
|
| Rate for Payer: Meridian Medicaid |
$255.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$396.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$379.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,172.63
|
| Rate for Payer: Nomi Health Commercial |
$1,131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,034.68
|
| Rate for Payer: PACE Senior Care Partners |
$327.65
|
| Rate for Payer: PACE SWMI |
$344.89
|
| Rate for Payer: PHP Commercial |
$1,172.63
|
| Rate for Payer: PHP Medicare Advantage |
$344.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$243.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,200.23
|
| Rate for Payer: Priority Health Medicare |
$348.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$960.18
|
| Rate for Payer: Railroad Medicare Medicare |
$344.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.02
|
| Rate for Payer: UHC Core |
$1,151.94
|
| Rate for Payer: UHC Exchange |
$344.89
|
| Rate for Payer: UHC Medicaid |
$243.22
|
| Rate for Payer: UHC Medicare Advantage |
$344.89
|
| Rate for Payer: UHCCP Medicaid |
$243.22
|
| Rate for Payer: VA VA |
$344.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,034.68
|
|
|
HC SAFE SHEATH LEAD INTRODUCER
|
Facility
|
OP
|
$2,000.00
|
|
| Hospital Charge Code |
27200400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$352.60 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$1,700.00
|
| Rate for Payer: Aetna Medicare |
$520.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.00
|
| Rate for Payer: BCBS Complete |
$370.20
|
| Rate for Payer: BCBS MAPPO |
$500.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.20
|
| Rate for Payer: BCN Commercial |
$1,644.20
|
| Rate for Payer: BCN Medicare Advantage |
$500.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$1,720.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.00
|
| Rate for Payer: Healthscope Commercial |
$1,800.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.00
|
| Rate for Payer: Mclaren Medicaid |
$352.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.00
|
| Rate for Payer: Meridian Medicaid |
$370.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$550.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.00
|
| Rate for Payer: Nomi Health Commercial |
$1,640.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PACE Senior Care Partners |
$475.00
|
| Rate for Payer: PACE SWMI |
$500.00
|
| Rate for Payer: PHP Commercial |
$1,700.00
|
| Rate for Payer: PHP Medicare Advantage |
$500.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,740.00
|
| Rate for Payer: Priority Health Medicare |
$505.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,392.00
|
| Rate for Payer: Railroad Medicare Medicare |
$500.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.00
|
| Rate for Payer: UHC Core |
$1,670.00
|
| Rate for Payer: UHC Exchange |
$500.00
|
| Rate for Payer: UHC Medicaid |
$352.60
|
| Rate for Payer: UHC Medicare Advantage |
$500.00
|
| Rate for Payer: UHCCP Medicaid |
$352.60
|
| Rate for Payer: VA VA |
$500.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.00
|
|
|
HC SAFE SHEATH LEAD INTRODUCER
|
Facility
|
IP
|
$2,000.00
|
|
| Hospital Charge Code |
27200400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$1,700.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.80
|
| Rate for Payer: BCN Commercial |
$1,651.80
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$1,720.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.00
|
| Rate for Payer: Healthscope Commercial |
$1,800.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.00
|
| Rate for Payer: Nomi Health Commercial |
$1,640.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PHP Commercial |
$1,700.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,740.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,392.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.00
|
| Rate for Payer: UHC Core |
$1,670.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.00
|
|
|
HC SALICYLATE LVL.
|
Facility
|
IP
|
$104.49
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100649
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.73 |
| Max. Negotiated Rate |
$94.04 |
| Rate for Payer: Aetna Commercial |
$88.82
|
| Rate for Payer: BCBS Trust/PPO |
$86.30
|
| Rate for Payer: BCN Commercial |
$86.30
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$89.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$85.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PHP Commercial |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.95
|
| Rate for Payer: UHC Core |
$87.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.37
|
|
|
HC SALICYLATE LVL.
|
Facility
|
OP
|
$104.49
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100649
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.42 |
| Max. Negotiated Rate |
$94.04 |
| Rate for Payer: Aetna Commercial |
$88.82
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.65
|
| Rate for Payer: BCBS Complete |
$19.34
|
| Rate for Payer: BCBS MAPPO |
$26.12
|
| Rate for Payer: BCBS Trust/PPO |
$85.90
|
| Rate for Payer: BCN Commercial |
$85.90
|
| Rate for Payer: BCN Medicare Advantage |
$26.12
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$89.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.12
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.37
|
| Rate for Payer: Mclaren Medicaid |
$18.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.43
|
| Rate for Payer: Meridian Medicaid |
$19.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$85.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PACE Senior Care Partners |
$24.82
|
| Rate for Payer: PACE SWMI |
$26.12
|
| Rate for Payer: PHP Commercial |
$88.82
|
| Rate for Payer: PHP Medicare Advantage |
$26.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.91
|
| Rate for Payer: Priority Health Medicare |
$26.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.73
|
| Rate for Payer: Railroad Medicare Medicare |
$26.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.95
|
| Rate for Payer: UHC Core |
$87.25
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicaid |
$18.42
|
| Rate for Payer: UHC Medicare Advantage |
$26.12
|
| Rate for Payer: UHCCP Medicaid |
$18.42
|
| Rate for Payer: VA VA |
$26.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.37
|
|
|
HC SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| 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 SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| 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 SALMON IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
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 SALMON IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
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 SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
OP
|
$12,927.24
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$2,279.07 |
| Max. Negotiated Rate |
$11,634.52 |
| Rate for Payer: Aetna Commercial |
$10,988.15
|
| Rate for Payer: Aetna Medicare |
$3,361.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,039.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,039.76
|
| Rate for Payer: BCBS Complete |
$2,392.83
|
| Rate for Payer: BCBS MAPPO |
$3,231.81
|
| Rate for Payer: BCBS Trust/PPO |
$10,627.48
|
| Rate for Payer: BCN Commercial |
$10,627.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,231.81
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cofinity Commercial |
$11,117.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,341.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,231.81
|
| Rate for Payer: Healthscope Commercial |
$11,634.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,695.43
|
| Rate for Payer: Mclaren Medicaid |
$2,279.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,393.40
|
| Rate for Payer: Meridian Medicaid |
$2,392.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,716.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,554.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,988.15
|
| Rate for Payer: Nomi Health Commercial |
$10,600.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,695.43
|
| Rate for Payer: PACE Senior Care Partners |
$3,070.22
|
| Rate for Payer: PACE SWMI |
$3,231.81
|
| Rate for Payer: PHP Commercial |
$10,988.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,231.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,279.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,246.70
|
| Rate for Payer: Priority Health Medicare |
$3,264.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,997.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,231.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,375.97
|
| Rate for Payer: UHC Core |
$10,794.25
|
| Rate for Payer: UHC Exchange |
$3,231.81
|
| Rate for Payer: UHC Medicaid |
$2,279.07
|
| Rate for Payer: UHC Medicare Advantage |
$3,231.81
|
| Rate for Payer: UHCCP Medicaid |
$2,279.07
|
| Rate for Payer: VA VA |
$3,231.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,695.43
|
|
|
HC SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
IP
|
$12,927.24
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$8,997.36 |
| Max. Negotiated Rate |
$11,634.52 |
| Rate for Payer: Aetna Commercial |
$10,988.15
|
| Rate for Payer: BCBS Trust/PPO |
$10,676.61
|
| Rate for Payer: BCN Commercial |
$10,676.61
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cofinity Commercial |
$11,117.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,341.79
|
| Rate for Payer: Healthscope Commercial |
$11,634.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,695.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,988.15
|
| Rate for Payer: Nomi Health Commercial |
$10,600.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,695.43
|
| Rate for Payer: PHP Commercial |
$10,988.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,246.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,997.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,375.97
|
| Rate for Payer: UHC Core |
$10,794.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,695.43
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.72 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna Medicare |
$18.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.55
|
| Rate for Payer: BCBS Complete |
$13.36
|
| Rate for Payer: BCBS MAPPO |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$59.33
|
| Rate for Payer: BCN Commercial |
$59.33
|
| Rate for Payer: BCN Medicare Advantage |
$18.04
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.04
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Mclaren Medicaid |
$12.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.94
|
| Rate for Payer: Meridian Medicaid |
$13.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Senior Care Partners |
$17.14
|
| Rate for Payer: PACE SWMI |
$18.04
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: PHP Medicare Advantage |
$18.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Medicare |
$18.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: Railroad Medicare Medicare |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: UHC Exchange |
$18.04
|
| Rate for Payer: UHC Medicaid |
$12.72
|
| Rate for Payer: UHC Medicare Advantage |
$18.04
|
| Rate for Payer: UHCCP Medicaid |
$12.72
|
| Rate for Payer: VA VA |
$18.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$59.61
|
| Rate for Payer: BCN Commercial |
$59.61
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC SARS-COV-2 COVID-19 AMP PRB
|
Facility
|
OP
|
$167.08
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.46 |
| Max. Negotiated Rate |
$150.37 |
| Rate for Payer: Aetna Commercial |
$142.02
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: BCBS Complete |
$30.93
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$137.36
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$133.66
|
| Rate for Payer: Cofinity Commercial |
$143.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$150.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.31
|
| Rate for Payer: Mclaren Medicaid |
$29.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: Meridian Medicaid |
$30.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.02
|
| Rate for Payer: Nomi Health Commercial |
$137.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.31
|
| Rate for Payer: PACE Senior Care Partners |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$142.02
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.36
|
| Rate for Payer: Priority Health Medicare |
$42.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.29
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.03
|
| Rate for Payer: UHC Core |
$139.51
|
| Rate for Payer: UHC Exchange |
$41.77
|
| Rate for Payer: UHC Medicaid |
$29.46
|
| Rate for Payer: UHC Medicare Advantage |
$41.77
|
| Rate for Payer: UHCCP Medicaid |
$29.46
|
| Rate for Payer: VA VA |
$41.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.31
|
|
|
HC SARS-COV-2 COVID-19 AMP PRB
|
Facility
|
IP
|
$167.08
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$116.29 |
| Max. Negotiated Rate |
$150.37 |
| Rate for Payer: Aetna Commercial |
$142.02
|
| Rate for Payer: BCBS Trust/PPO |
$137.99
|
| Rate for Payer: BCN Commercial |
$137.99
|
| Rate for Payer: Cash Price |
$133.66
|
| Rate for Payer: Cofinity Commercial |
$143.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.66
|
| Rate for Payer: Healthscope Commercial |
$150.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.02
|
| Rate for Payer: Nomi Health Commercial |
$137.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.31
|
| Rate for Payer: PHP Commercial |
$142.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.03
|
| Rate for Payer: UHC Core |
$139.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.31
|
|
|
HC SARS-COV2/FLU A&B
|
Facility
|
IP
|
$222.85
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
30600318
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$200.56 |
| Rate for Payer: Aetna Commercial |
$189.42
|
| Rate for Payer: BCBS Trust/PPO |
$184.05
|
| Rate for Payer: BCN Commercial |
$184.05
|
| Rate for Payer: Cash Price |
$178.28
|
| Rate for Payer: Cofinity Commercial |
$191.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.28
|
| Rate for Payer: Healthscope Commercial |
$200.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.42
|
| Rate for Payer: Nomi Health Commercial |
$182.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.14
|
| Rate for Payer: PHP Commercial |
$189.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$193.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.11
|
| Rate for Payer: UHC Core |
$186.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.14
|
|
|
HC SARS-COV2/FLU A&B
|
Facility
|
OP
|
$222.85
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
30600318
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.29 |
| Max. Negotiated Rate |
$200.56 |
| Rate for Payer: Aetna Commercial |
$189.42
|
| Rate for Payer: Aetna Medicare |
$57.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.64
|
| Rate for Payer: BCBS Complete |
$41.25
|
| Rate for Payer: BCBS MAPPO |
$55.71
|
| Rate for Payer: BCBS Trust/PPO |
$183.20
|
| Rate for Payer: BCN Commercial |
$183.20
|
| Rate for Payer: BCN Medicare Advantage |
$55.71
|
| Rate for Payer: Cash Price |
$178.28
|
| Rate for Payer: Cofinity Commercial |
$191.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.71
|
| Rate for Payer: Healthscope Commercial |
$200.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.14
|
| Rate for Payer: Mclaren Medicaid |
$39.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.50
|
| Rate for Payer: Meridian Medicaid |
$41.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.42
|
| Rate for Payer: Nomi Health Commercial |
$182.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.14
|
| Rate for Payer: PACE Senior Care Partners |
$52.93
|
| Rate for Payer: PACE SWMI |
$55.71
|
| Rate for Payer: PHP Commercial |
$189.42
|
| Rate for Payer: PHP Medicare Advantage |
$55.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$193.88
|
| Rate for Payer: Priority Health Medicare |
$56.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.10
|
| Rate for Payer: Railroad Medicare Medicare |
$55.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.11
|
| Rate for Payer: UHC Core |
$186.08
|
| Rate for Payer: UHC Exchange |
$55.71
|
| Rate for Payer: UHC Medicaid |
$39.29
|
| Rate for Payer: UHC Medicare Advantage |
$55.71
|
| Rate for Payer: UHCCP Medicaid |
$39.29
|
| Rate for Payer: VA VA |
$55.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.14
|
|
|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.84 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$221.00
|
| Rate for Payer: Aetna Medicare |
$67.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.25
|
| Rate for Payer: BCBS Complete |
$48.13
|
| Rate for Payer: BCBS MAPPO |
$65.00
|
| Rate for Payer: BCBS Trust/PPO |
$213.75
|
| Rate for Payer: BCN Commercial |
$213.75
|
| Rate for Payer: BCN Medicare Advantage |
$65.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$223.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.00
|
| Rate for Payer: Healthscope Commercial |
$234.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.00
|
| Rate for Payer: Mclaren Medicaid |
$45.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.25
|
| Rate for Payer: Meridian Medicaid |
$48.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Nomi Health Commercial |
$213.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE Senior Care Partners |
$61.75
|
| Rate for Payer: PACE SWMI |
$65.00
|
| Rate for Payer: PHP Commercial |
$221.00
|
| Rate for Payer: PHP Medicare Advantage |
$65.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.20
|
| Rate for Payer: Priority Health Medicare |
$65.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.96
|
| Rate for Payer: Railroad Medicare Medicare |
$65.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.80
|
| Rate for Payer: UHC Core |
$217.10
|
| Rate for Payer: UHC Exchange |
$65.00
|
| Rate for Payer: UHC Medicaid |
$45.84
|
| Rate for Payer: UHC Medicare Advantage |
$65.00
|
| Rate for Payer: UHCCP Medicaid |
$45.84
|
| Rate for Payer: VA VA |
$65.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.00
|
|
|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$180.96 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$221.00
|
| Rate for Payer: BCBS Trust/PPO |
$214.73
|
| Rate for Payer: BCN Commercial |
$214.73
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$223.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.00
|
| Rate for Payer: Healthscope Commercial |
$234.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Nomi Health Commercial |
$213.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PHP Commercial |
$221.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.80
|
| Rate for Payer: UHC Core |
$217.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.00
|
|
|
HC SARSCOV2 INF AB RSV AMP PRB
|
Facility
|
OP
|
$255.32
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600344
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.01 |
| Max. Negotiated Rate |
$229.79 |
| Rate for Payer: Aetna Commercial |
$217.02
|
| Rate for Payer: Aetna Medicare |
$66.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.79
|
| Rate for Payer: BCBS Complete |
$47.26
|
| Rate for Payer: BCBS MAPPO |
$63.83
|
| Rate for Payer: BCBS Trust/PPO |
$209.90
|
| Rate for Payer: BCN Commercial |
$209.90
|
| Rate for Payer: BCN Medicare Advantage |
$63.83
|
| Rate for Payer: Cash Price |
$204.26
|
| Rate for Payer: Cofinity Commercial |
$219.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.83
|
| Rate for Payer: Healthscope Commercial |
$229.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.49
|
| Rate for Payer: Mclaren Medicaid |
$45.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.02
|
| Rate for Payer: Meridian Medicaid |
$47.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.02
|
| Rate for Payer: Nomi Health Commercial |
$209.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.49
|
| Rate for Payer: PACE Senior Care Partners |
$60.64
|
| Rate for Payer: PACE SWMI |
$63.83
|
| Rate for Payer: PHP Commercial |
$217.02
|
| Rate for Payer: PHP Medicare Advantage |
$63.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.13
|
| Rate for Payer: Priority Health Medicare |
$64.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.70
|
| Rate for Payer: Railroad Medicare Medicare |
$63.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.68
|
| Rate for Payer: UHC Core |
$213.19
|
| Rate for Payer: UHC Exchange |
$63.83
|
| Rate for Payer: UHC Medicaid |
$45.01
|
| Rate for Payer: UHC Medicare Advantage |
$63.83
|
| Rate for Payer: UHCCP Medicaid |
$45.01
|
| Rate for Payer: VA VA |
$63.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.49
|
|
|
HC SARSCOV2 INF AB RSV AMP PRB
|
Facility
|
IP
|
$255.32
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600344
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$177.70 |
| Max. Negotiated Rate |
$229.79 |
| Rate for Payer: Aetna Commercial |
$217.02
|
| Rate for Payer: BCBS Trust/PPO |
$210.87
|
| Rate for Payer: BCN Commercial |
$210.87
|
| Rate for Payer: Cash Price |
$204.26
|
| Rate for Payer: Cofinity Commercial |
$219.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.26
|
| Rate for Payer: Healthscope Commercial |
$229.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.02
|
| Rate for Payer: Nomi Health Commercial |
$209.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.49
|
| Rate for Payer: PHP Commercial |
$217.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.68
|
| Rate for Payer: UHC Core |
$213.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.49
|
|
|
HC SARSCOV2 INF AB RSV PCR CEPHEID
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600356
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$173.93 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: BCBS Trust/PPO |
$206.39
|
| Rate for Payer: BCN Commercial |
$206.39
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.43
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
HC SARSCOV2 INF AB RSV PCR CEPHEID
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600356
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.06 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$46.26
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$205.44
|
| Rate for Payer: BCN Commercial |
$205.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.43
|
| Rate for Payer: Mclaren Medicaid |
$44.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$46.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.43
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$63.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.93
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Exchange |
$62.48
|
| Rate for Payer: UHC Medicaid |
$44.06
|
| Rate for Payer: UHC Medicare Advantage |
$62.48
|
| Rate for Payer: UHCCP Medicaid |
$44.06
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
