|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$223.51
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$155.56 |
| Max. Negotiated Rate |
$201.16 |
| Rate for Payer: Aetna Commercial |
$189.98
|
| Rate for Payer: BCBS Trust/PPO |
$184.60
|
| Rate for Payer: BCN Commercial |
$184.60
|
| Rate for Payer: Cash Price |
$178.81
|
| Rate for Payer: Cofinity Commercial |
$192.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.81
|
| Rate for Payer: Healthscope Commercial |
$201.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.98
|
| Rate for Payer: Nomi Health Commercial |
$183.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.63
|
| Rate for Payer: PHP Commercial |
$189.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.69
|
| Rate for Payer: UHC Core |
$186.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.63
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$223.51
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.40 |
| Max. Negotiated Rate |
$201.16 |
| Rate for Payer: Aetna Commercial |
$189.98
|
| Rate for Payer: Aetna Medicare |
$58.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.85
|
| Rate for Payer: BCBS Complete |
$41.37
|
| Rate for Payer: BCBS MAPPO |
$55.88
|
| Rate for Payer: BCBS Trust/PPO |
$183.75
|
| Rate for Payer: BCN Commercial |
$183.75
|
| Rate for Payer: BCN Medicare Advantage |
$55.88
|
| Rate for Payer: Cash Price |
$178.81
|
| Rate for Payer: Cofinity Commercial |
$192.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.88
|
| Rate for Payer: Healthscope Commercial |
$201.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.63
|
| Rate for Payer: Mclaren Medicaid |
$39.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.67
|
| Rate for Payer: Meridian Medicaid |
$41.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.98
|
| Rate for Payer: Nomi Health Commercial |
$183.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.63
|
| Rate for Payer: PACE Senior Care Partners |
$53.08
|
| Rate for Payer: PACE SWMI |
$55.88
|
| Rate for Payer: PHP Commercial |
$189.98
|
| Rate for Payer: PHP Medicare Advantage |
$55.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.45
|
| Rate for Payer: Priority Health Medicare |
$56.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.56
|
| Rate for Payer: Railroad Medicare Medicare |
$55.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.69
|
| Rate for Payer: UHC Core |
$186.63
|
| Rate for Payer: UHC Exchange |
$55.88
|
| Rate for Payer: UHC Medicaid |
$39.40
|
| Rate for Payer: UHC Medicare Advantage |
$55.88
|
| Rate for Payer: UHCCP Medicaid |
$39.40
|
| Rate for Payer: VA VA |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.63
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$333.82
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.85 |
| Max. Negotiated Rate |
$300.44 |
| Rate for Payer: Aetna Commercial |
$283.75
|
| Rate for Payer: Aetna Medicare |
$86.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.32
|
| Rate for Payer: BCBS Complete |
$61.79
|
| Rate for Payer: BCBS MAPPO |
$83.45
|
| Rate for Payer: BCBS Trust/PPO |
$274.43
|
| Rate for Payer: BCN Commercial |
$274.43
|
| Rate for Payer: BCN Medicare Advantage |
$83.45
|
| Rate for Payer: Cash Price |
$267.06
|
| Rate for Payer: Cofinity Commercial |
$287.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.45
|
| Rate for Payer: Healthscope Commercial |
$300.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.37
|
| Rate for Payer: Mclaren Medicaid |
$58.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.63
|
| Rate for Payer: Meridian Medicaid |
$61.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.75
|
| Rate for Payer: Nomi Health Commercial |
$273.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.37
|
| Rate for Payer: PACE Senior Care Partners |
$79.28
|
| Rate for Payer: PACE SWMI |
$83.45
|
| Rate for Payer: PHP Commercial |
$283.75
|
| Rate for Payer: PHP Medicare Advantage |
$83.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$290.42
|
| Rate for Payer: Priority Health Medicare |
$84.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.34
|
| Rate for Payer: Railroad Medicare Medicare |
$83.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.76
|
| Rate for Payer: UHC Core |
$278.74
|
| Rate for Payer: UHC Exchange |
$83.45
|
| Rate for Payer: UHC Medicaid |
$58.85
|
| Rate for Payer: UHC Medicare Advantage |
$83.45
|
| Rate for Payer: UHCCP Medicaid |
$58.85
|
| Rate for Payer: VA VA |
$83.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.37
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$333.82
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$232.34 |
| Max. Negotiated Rate |
$300.44 |
| Rate for Payer: Aetna Commercial |
$283.75
|
| Rate for Payer: BCBS Trust/PPO |
$275.70
|
| Rate for Payer: BCN Commercial |
$275.70
|
| Rate for Payer: Cash Price |
$267.06
|
| Rate for Payer: Cofinity Commercial |
$287.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.06
|
| Rate for Payer: Healthscope Commercial |
$300.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.75
|
| Rate for Payer: Nomi Health Commercial |
$273.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.37
|
| Rate for Payer: PHP Commercial |
$283.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$290.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.76
|
| Rate for Payer: UHC Core |
$278.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.37
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$166.92
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.43 |
| Max. Negotiated Rate |
$150.23 |
| Rate for Payer: Aetna Commercial |
$141.88
|
| Rate for Payer: Aetna Medicare |
$43.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.16
|
| Rate for Payer: BCBS Complete |
$30.90
|
| Rate for Payer: BCBS MAPPO |
$41.73
|
| Rate for Payer: BCBS Trust/PPO |
$137.22
|
| Rate for Payer: BCN Commercial |
$137.22
|
| Rate for Payer: BCN Medicare Advantage |
$41.73
|
| Rate for Payer: Cash Price |
$133.54
|
| Rate for Payer: Cofinity Commercial |
$143.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.73
|
| Rate for Payer: Healthscope Commercial |
$150.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.19
|
| Rate for Payer: Mclaren Medicaid |
$29.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.82
|
| Rate for Payer: Meridian Medicaid |
$30.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.88
|
| Rate for Payer: Nomi Health Commercial |
$136.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.19
|
| Rate for Payer: PACE Senior Care Partners |
$39.64
|
| Rate for Payer: PACE SWMI |
$41.73
|
| Rate for Payer: PHP Commercial |
$141.88
|
| Rate for Payer: PHP Medicare Advantage |
$41.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.22
|
| Rate for Payer: Priority Health Medicare |
$42.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.18
|
| Rate for Payer: Railroad Medicare Medicare |
$41.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.89
|
| Rate for Payer: UHC Core |
$139.38
|
| Rate for Payer: UHC Exchange |
$41.73
|
| Rate for Payer: UHC Medicaid |
$29.43
|
| Rate for Payer: UHC Medicare Advantage |
$41.73
|
| Rate for Payer: UHCCP Medicaid |
$29.43
|
| Rate for Payer: VA VA |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.19
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$166.92
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$116.18 |
| Max. Negotiated Rate |
$150.23 |
| Rate for Payer: Aetna Commercial |
$141.88
|
| Rate for Payer: BCBS Trust/PPO |
$137.86
|
| Rate for Payer: BCN Commercial |
$137.86
|
| Rate for Payer: Cash Price |
$133.54
|
| Rate for Payer: Cofinity Commercial |
$143.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.54
|
| Rate for Payer: Healthscope Commercial |
$150.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.88
|
| Rate for Payer: Nomi Health Commercial |
$136.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.19
|
| Rate for Payer: PHP Commercial |
$141.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.89
|
| Rate for Payer: UHC Core |
$139.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.19
|
|
|
HC SARSCOV2 VAC 5MCG/0.5ML IM NOVAVAX
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT 91304
|
| Hospital Charge Code |
63600211
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SARSCOV2 VAC 5MCG/0.5ML IM NOVAVAX
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT 91304
|
| Hospital Charge Code |
63600211
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE
|
Facility
|
OP
|
$345.69
|
|
|
Service Code
|
CPT 91321
|
| Hospital Charge Code |
63600276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.95 |
| Max. Negotiated Rate |
$311.12 |
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: Aetna Medicare |
$89.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.03
|
| Rate for Payer: BCBS Complete |
$63.99
|
| Rate for Payer: BCBS MAPPO |
$86.42
|
| Rate for Payer: BCBS Trust/PPO |
$284.19
|
| Rate for Payer: BCN Commercial |
$284.19
|
| Rate for Payer: BCN Medicare Advantage |
$86.42
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.42
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: Mclaren Medicaid |
$60.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.74
|
| Rate for Payer: Meridian Medicaid |
$63.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Nomi Health Commercial |
$283.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PACE Senior Care Partners |
$82.10
|
| Rate for Payer: PACE SWMI |
$86.42
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: PHP Medicare Advantage |
$86.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.75
|
| Rate for Payer: Priority Health Medicare |
$87.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.60
|
| Rate for Payer: Railroad Medicare Medicare |
$86.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.21
|
| Rate for Payer: UHC Core |
$288.65
|
| Rate for Payer: UHC Exchange |
$86.42
|
| Rate for Payer: UHC Medicaid |
$60.95
|
| Rate for Payer: UHC Medicare Advantage |
$86.42
|
| Rate for Payer: UHCCP Medicaid |
$60.95
|
| Rate for Payer: VA VA |
$86.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE
|
Facility
|
IP
|
$345.69
|
|
|
Service Code
|
CPT 91321
|
| Hospital Charge Code |
63600276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$240.60 |
| Max. Negotiated Rate |
$311.12 |
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: BCBS Trust/PPO |
$285.51
|
| Rate for Payer: BCN Commercial |
$285.51
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Nomi Health Commercial |
$283.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.21
|
| Rate for Payer: UHC Core |
$288.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE
|
Facility
|
OP
|
$345.69
|
|
|
Service Code
|
CPT 91322
|
| Hospital Charge Code |
63600277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.95 |
| Max. Negotiated Rate |
$311.12 |
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: Aetna Medicare |
$89.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.03
|
| Rate for Payer: BCBS Complete |
$63.99
|
| Rate for Payer: BCBS MAPPO |
$86.42
|
| Rate for Payer: BCBS Trust/PPO |
$284.19
|
| Rate for Payer: BCN Commercial |
$284.19
|
| Rate for Payer: BCN Medicare Advantage |
$86.42
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.42
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: Mclaren Medicaid |
$60.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.74
|
| Rate for Payer: Meridian Medicaid |
$63.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Nomi Health Commercial |
$283.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PACE Senior Care Partners |
$82.10
|
| Rate for Payer: PACE SWMI |
$86.42
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: PHP Medicare Advantage |
$86.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.75
|
| Rate for Payer: Priority Health Medicare |
$87.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.60
|
| Rate for Payer: Railroad Medicare Medicare |
$86.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.21
|
| Rate for Payer: UHC Core |
$288.65
|
| Rate for Payer: UHC Exchange |
$86.42
|
| Rate for Payer: UHC Medicaid |
$60.95
|
| Rate for Payer: UHC Medicare Advantage |
$86.42
|
| Rate for Payer: UHCCP Medicaid |
$60.95
|
| Rate for Payer: VA VA |
$86.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE
|
Facility
|
IP
|
$345.69
|
|
|
Service Code
|
CPT 91322
|
| Hospital Charge Code |
63600277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$240.60 |
| Max. Negotiated Rate |
$311.12 |
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: BCBS Trust/PPO |
$285.51
|
| Rate for Payer: BCN Commercial |
$285.51
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Nomi Health Commercial |
$283.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.21
|
| Rate for Payer: UHC Core |
$288.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV AG
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC SARSCOV AG
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
IP
|
$63.25
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.02 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.24
|
| Rate for Payer: BCN Commercial |
$52.24
|
| Rate for Payer: Cash Price |
$50.60
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.60
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.76
|
| Rate for Payer: Nomi Health Commercial |
$51.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.44
|
| Rate for Payer: PHP Commercial |
$53.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.66
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
OP
|
$63.25
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.76
|
| Rate for Payer: Aetna Medicare |
$16.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.77
|
| Rate for Payer: BCBS Complete |
$11.71
|
| Rate for Payer: BCBS MAPPO |
$15.81
|
| Rate for Payer: BCBS Trust/PPO |
$52.00
|
| Rate for Payer: BCN Commercial |
$52.00
|
| Rate for Payer: BCN Medicare Advantage |
$15.81
|
| Rate for Payer: Cash Price |
$50.60
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.81
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Mclaren Medicaid |
$11.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.60
|
| Rate for Payer: Meridian Medicaid |
$11.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.76
|
| Rate for Payer: Nomi Health Commercial |
$51.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.44
|
| Rate for Payer: PACE Senior Care Partners |
$15.02
|
| Rate for Payer: PACE SWMI |
$15.81
|
| Rate for Payer: PHP Commercial |
$53.76
|
| Rate for Payer: PHP Medicare Advantage |
$15.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.03
|
| Rate for Payer: Priority Health Medicare |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.02
|
| Rate for Payer: Railroad Medicare Medicare |
$15.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.66
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: UHC Exchange |
$15.81
|
| Rate for Payer: UHC Medicaid |
$11.15
|
| Rate for Payer: UHC Medicare Advantage |
$15.81
|
| Rate for Payer: UHCCP Medicaid |
$11.15
|
| Rate for Payer: VA VA |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC SARS FLU AB RSV
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
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 FLU AB RSV
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
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 SCALLOP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
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 SCALLOP IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
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 SCALP ELECTRODE
|
Facility
|
OP
|
$136.45
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$122.81 |
| Rate for Payer: Aetna Commercial |
$115.98
|
| Rate for Payer: Aetna Medicare |
$35.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.64
|
| Rate for Payer: BCBS Complete |
$25.26
|
| Rate for Payer: BCBS MAPPO |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$112.18
|
| Rate for Payer: BCN Commercial |
$112.18
|
| Rate for Payer: BCN Medicare Advantage |
$34.11
|
| Rate for Payer: Cash Price |
$109.16
|
| Rate for Payer: Cofinity Commercial |
$117.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.11
|
| Rate for Payer: Healthscope Commercial |
$122.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.34
|
| Rate for Payer: Mclaren Medicaid |
$24.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.82
|
| Rate for Payer: Meridian Medicaid |
$25.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.98
|
| Rate for Payer: Nomi Health Commercial |
$111.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.34
|
| Rate for Payer: PACE Senior Care Partners |
$32.41
|
| Rate for Payer: PACE SWMI |
$34.11
|
| Rate for Payer: PHP Commercial |
$115.98
|
| Rate for Payer: PHP Medicare Advantage |
$34.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.71
|
| Rate for Payer: Priority Health Medicare |
$34.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.97
|
| Rate for Payer: Railroad Medicare Medicare |
$34.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.08
|
| Rate for Payer: UHC Core |
$113.94
|
| Rate for Payer: UHC Exchange |
$34.11
|
| Rate for Payer: UHC Medicaid |
$24.06
|
| Rate for Payer: UHC Medicare Advantage |
$34.11
|
| Rate for Payer: UHCCP Medicaid |
$24.06
|
| Rate for Payer: VA VA |
$34.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.34
|
|
|
HC SCALP ELECTRODE
|
Facility
|
IP
|
$136.45
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$94.97 |
| Max. Negotiated Rate |
$122.81 |
| Rate for Payer: Aetna Commercial |
$115.98
|
| Rate for Payer: BCBS Trust/PPO |
$112.69
|
| Rate for Payer: BCN Commercial |
$112.69
|
| Rate for Payer: Cash Price |
$109.16
|
| Rate for Payer: Cofinity Commercial |
$117.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.16
|
| Rate for Payer: Healthscope Commercial |
$122.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.98
|
| Rate for Payer: Nomi Health Commercial |
$111.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.34
|
| Rate for Payer: PHP Commercial |
$115.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.08
|
| Rate for Payer: UHC Core |
$113.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.34
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$101.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.94 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna Commercial |
$86.50
|
| Rate for Payer: Aetna Medicare |
$26.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.80
|
| Rate for Payer: BCBS Complete |
$18.84
|
| Rate for Payer: BCBS MAPPO |
$25.44
|
| Rate for Payer: BCBS Trust/PPO |
$83.66
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: BCN Medicare Advantage |
$25.44
|
| Rate for Payer: Cash Price |
$81.41
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.44
|
| Rate for Payer: Healthscope Commercial |
$91.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.32
|
| Rate for Payer: Mclaren Medicaid |
$17.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.71
|
| Rate for Payer: Meridian Medicaid |
$18.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.50
|
| Rate for Payer: Nomi Health Commercial |
$83.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.32
|
| Rate for Payer: PACE Senior Care Partners |
$24.17
|
| Rate for Payer: PACE SWMI |
$25.44
|
| Rate for Payer: PHP Commercial |
$86.50
|
| Rate for Payer: PHP Medicare Advantage |
$25.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.53
|
| Rate for Payer: Priority Health Medicare |
$25.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.82
|
| Rate for Payer: Railroad Medicare Medicare |
$25.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.55
|
| Rate for Payer: UHC Core |
$84.97
|
| Rate for Payer: UHC Exchange |
$25.44
|
| Rate for Payer: UHC Medicaid |
$17.94
|
| Rate for Payer: UHC Medicare Advantage |
$25.44
|
| Rate for Payer: UHCCP Medicaid |
$17.94
|
| Rate for Payer: VA VA |
$25.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.32
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$101.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.82 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna Commercial |
$86.50
|
| Rate for Payer: BCBS Trust/PPO |
$84.04
|
| Rate for Payer: BCN Commercial |
$84.04
|
| Rate for Payer: Cash Price |
$81.41
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.41
|
| Rate for Payer: Healthscope Commercial |
$91.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.50
|
| Rate for Payer: Nomi Health Commercial |
$83.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.32
|
| Rate for Payer: PHP Commercial |
$86.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.55
|
| Rate for Payer: UHC Core |
$84.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.32
|
|
|
HC SCISSORS
|
Facility
|
OP
|
$18.02
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$16.22 |
| Rate for Payer: Aetna Commercial |
$15.32
|
| Rate for Payer: Aetna Medicare |
$4.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.63
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS MAPPO |
$4.50
|
| Rate for Payer: BCBS Trust/PPO |
$14.81
|
| Rate for Payer: BCN Commercial |
$14.81
|
| Rate for Payer: BCN Medicare Advantage |
$4.50
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cofinity Commercial |
$15.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.50
|
| Rate for Payer: Healthscope Commercial |
$16.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.52
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.73
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.32
|
| Rate for Payer: Nomi Health Commercial |
$14.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.52
|
| Rate for Payer: PACE Senior Care Partners |
$4.28
|
| Rate for Payer: PACE SWMI |
$4.50
|
| Rate for Payer: PHP Commercial |
$15.32
|
| Rate for Payer: PHP Medicare Advantage |
$4.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.68
|
| Rate for Payer: Priority Health Medicare |
$4.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.54
|
| Rate for Payer: Railroad Medicare Medicare |
$4.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.86
|
| Rate for Payer: UHC Core |
$15.05
|
| Rate for Payer: UHC Exchange |
$4.50
|
| Rate for Payer: UHC Medicaid |
$3.18
|
| Rate for Payer: UHC Medicare Advantage |
$4.50
|
| Rate for Payer: UHCCP Medicaid |
$3.18
|
| Rate for Payer: VA VA |
$4.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.52
|
|
