|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$250.47 |
| Max. Negotiated Rate |
$949.15 |
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: Aetna Medicare |
$274.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.57
|
| Rate for Payer: BCBS Complete |
$421.84
|
| Rate for Payer: BCBS MAPPO |
$263.65
|
| Rate for Payer: BCBS Trust/PPO |
$866.99
|
| Rate for Payer: BCN Commercial |
$819.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.65
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.65
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: Nomi Health Commercial |
$864.78
|
| Rate for Payer: PACE Senior Care Partners |
$250.47
|
| Rate for Payer: PACE SWMI |
$263.65
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: PHP Medicare Advantage |
$263.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health HMO/PPO |
$917.51
|
| Rate for Payer: Priority Health Medicare |
$266.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$706.59
|
| Rate for Payer: Railroad Medicare Medicare |
$263.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.06
|
| Rate for Payer: UHC Core |
$880.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.65
|
| Rate for Payer: UHC Exchange |
$263.65
|
| Rate for Payer: UHC Medicare Advantage |
$263.65
|
| Rate for Payer: VA VA |
$263.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$685.50 |
| Max. Negotiated Rate |
$949.15 |
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: BCBS Trust/PPO |
$860.88
|
| Rate for Payer: BCN Commercial |
$815.00
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: Nomi Health Commercial |
$864.78
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health HMO/PPO |
$917.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$706.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.06
|
| Rate for Payer: UHC Core |
$880.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: BCBS Trust/PPO |
$82.93
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: Nomi Health Commercial |
$83.30
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health HMO/PPO |
$88.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.40
|
| Rate for Payer: UHC Core |
$84.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: Aetna Medicare |
$26.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.75
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$25.40
|
| Rate for Payer: BCBS Trust/PPO |
$83.52
|
| Rate for Payer: BCN Commercial |
$78.99
|
| Rate for Payer: BCN Medicare Advantage |
$25.40
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.40
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.67
|
| Rate for Payer: Meridian Medicaid |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: Nomi Health Commercial |
$83.30
|
| Rate for Payer: PACE Senior Care Partners |
$24.13
|
| Rate for Payer: PACE SWMI |
$25.40
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: PHP Medicare Advantage |
$25.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health HMO/PPO |
$88.38
|
| Rate for Payer: Priority Health Medicare |
$25.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: Railroad Medicare Medicare |
$25.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.40
|
| Rate for Payer: UHC Core |
$84.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.40
|
| Rate for Payer: UHC Exchange |
$25.40
|
| Rate for Payer: UHC Medicare Advantage |
$25.40
|
| Rate for Payer: UHCCP Medicaid |
$9.47
|
| Rate for Payer: VA VA |
$25.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$73.24
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$19.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.89
|
| Rate for Payer: BCBS Complete |
$10.19
|
| Rate for Payer: BCBS MAPPO |
$18.31
|
| Rate for Payer: BCBS Trust/PPO |
$60.21
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$18.31
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Mclaren Medicaid |
$9.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.23
|
| Rate for Payer: Meridian Medicaid |
$10.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.06
|
| Rate for Payer: PACE Senior Care Partners |
$17.39
|
| Rate for Payer: PACE SWMI |
$18.31
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.61
|
| Rate for Payer: Priority Health HMO/PPO |
$63.72
|
| Rate for Payer: Priority Health Medicare |
$18.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.07
|
| Rate for Payer: Railroad Medicare Medicare |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.31
|
| Rate for Payer: UHC Exchange |
$18.31
|
| Rate for Payer: UHC Medicare Advantage |
$18.31
|
| Rate for Payer: UHCCP Medicaid |
$9.70
|
| Rate for Payer: VA VA |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$73.24
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.61 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: BCBS Trust/PPO |
$59.79
|
| Rate for Payer: BCN Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.06
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.61
|
| Rate for Payer: Priority Health HMO/PPO |
$63.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$18.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.99
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$17.60
|
| Rate for Payer: BCBS Trust/PPO |
$57.86
|
| Rate for Payer: BCN Commercial |
$54.72
|
| Rate for Payer: BCN Medicare Advantage |
$17.60
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.60
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.47
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PACE Senior Care Partners |
$16.72
|
| Rate for Payer: PACE SWMI |
$17.60
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$17.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: Railroad Medicare Medicare |
$17.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.60
|
| Rate for Payer: UHC Exchange |
$17.60
|
| Rate for Payer: UHC Medicare Advantage |
$17.60
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$17.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.45
|
| Rate for Payer: BCN Commercial |
$54.39
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$5,030.37
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,269.74 |
| Max. Negotiated Rate |
$4,527.33 |
| Rate for Payer: Aetna Commercial |
$4,275.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,106.29
|
| Rate for Payer: BCN Commercial |
$3,887.47
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cofinity Commercial |
$4,326.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,024.30
|
| Rate for Payer: Healthscope Commercial |
$4,527.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.81
|
| Rate for Payer: Nomi Health Commercial |
$4,124.90
|
| Rate for Payer: PHP Commercial |
$4,275.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,269.74
|
| Rate for Payer: Priority Health HMO/PPO |
$4,376.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,370.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,426.73
|
| Rate for Payer: UHC Core |
$4,200.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.78
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$5,030.37
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$520.47 |
| Max. Negotiated Rate |
$4,527.33 |
| Rate for Payer: Aetna Commercial |
$4,275.81
|
| Rate for Payer: Aetna Medicare |
$1,307.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,571.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,571.99
|
| Rate for Payer: BCBS Complete |
$546.53
|
| Rate for Payer: BCBS MAPPO |
$1,257.59
|
| Rate for Payer: BCBS Trust/PPO |
$4,135.47
|
| Rate for Payer: BCN Commercial |
$3,911.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.59
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cofinity Commercial |
$4,326.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,024.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.59
|
| Rate for Payer: Healthscope Commercial |
$4,527.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.78
|
| Rate for Payer: Mclaren Medicaid |
$520.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.47
|
| Rate for Payer: Meridian Medicaid |
$546.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,446.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.81
|
| Rate for Payer: Nomi Health Commercial |
$4,124.90
|
| Rate for Payer: PACE Senior Care Partners |
$1,194.71
|
| Rate for Payer: PACE SWMI |
$1,257.59
|
| Rate for Payer: PHP Commercial |
$4,275.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,269.74
|
| Rate for Payer: Priority Health HMO/PPO |
$4,376.42
|
| Rate for Payer: Priority Health Medicare |
$1,270.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,370.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,426.73
|
| Rate for Payer: UHC Core |
$4,200.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.59
|
| Rate for Payer: UHC Exchange |
$1,257.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.59
|
| Rate for Payer: UHCCP Medicaid |
$520.47
|
| Rate for Payer: VA VA |
$1,257.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.78
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.01
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$18.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: Meridian Medicaid |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.07
|
| Rate for Payer: Nomi Health Commercial |
$18.40
|
| Rate for Payer: PACE Senior Care Partners |
$5.33
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.59
|
| Rate for Payer: Priority Health HMO/PPO |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Exchange |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$5.61
|
| Rate for Payer: UHCCP Medicaid |
$9.47
|
| Rate for Payer: VA VA |
$5.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.59 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.32
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.07
|
| Rate for Payer: Nomi Health Commercial |
$18.40
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.59
|
| Rate for Payer: Priority Health HMO/PPO |
$19.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.60
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.60
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.60
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.60
|
| Rate for Payer: UHC Exchange |
$15.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.60
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.60
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.60
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.60
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.60
|
| Rate for Payer: UHC Exchange |
$15.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.60
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.60
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.60
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.60
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.60
|
| Rate for Payer: UHC Exchange |
$15.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.60
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$405.76 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: BCBS Trust/PPO |
$509.57
|
| Rate for Payer: BCN Commercial |
$482.41
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$148.26 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: Aetna Medicare |
$162.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.08
|
| Rate for Payer: BCBS Complete |
$316.42
|
| Rate for Payer: BCBS MAPPO |
$156.06
|
| Rate for Payer: BCBS Trust/PPO |
$513.19
|
| Rate for Payer: BCN Commercial |
$485.35
|
| Rate for Payer: BCN Medicare Advantage |
$156.06
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.06
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$301.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.86
|
| Rate for Payer: Meridian Medicaid |
$316.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: PACE Senior Care Partners |
$148.26
|
| Rate for Payer: PACE SWMI |
$156.06
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: PHP Medicare Advantage |
$156.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Medicare |
$157.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.24
|
| Rate for Payer: Railroad Medicare Medicare |
$156.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.06
|
| Rate for Payer: UHC Exchange |
$156.06
|
| Rate for Payer: UHC Medicare Advantage |
$156.06
|
| Rate for Payer: UHCCP Medicaid |
$301.33
|
| Rate for Payer: VA VA |
$156.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$18.85
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: Aetna Medicare |
$4.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.89
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$4.71
|
| Rate for Payer: BCBS Trust/PPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$4.71
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.71
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: Nomi Health Commercial |
$15.46
|
| Rate for Payer: PACE Senior Care Partners |
$4.48
|
| Rate for Payer: PACE SWMI |
$4.71
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.25
|
| Rate for Payer: Priority Health HMO/PPO |
$16.40
|
| Rate for Payer: Priority Health Medicare |
$4.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.63
|
| Rate for Payer: Railroad Medicare Medicare |
$4.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.59
|
| Rate for Payer: UHC Core |
$15.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.71
|
| Rate for Payer: UHC Exchange |
$4.71
|
| Rate for Payer: UHC Medicare Advantage |
$4.71
|
| Rate for Payer: VA VA |
$4.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$18.85
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: BCBS Trust/PPO |
$15.39
|
| Rate for Payer: BCN Commercial |
$14.57
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: Nomi Health Commercial |
$15.46
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.25
|
| Rate for Payer: Priority Health HMO/PPO |
$16.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.59
|
| Rate for Payer: UHC Core |
$15.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.21 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$213.07
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO |
$239.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.62
|
| Rate for Payer: UHC Core |
$230.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.48 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$71.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.16
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$68.93
|
| Rate for Payer: BCBS Trust/PPO |
$226.66
|
| Rate for Payer: BCN Commercial |
$214.36
|
| Rate for Payer: BCN Medicare Advantage |
$68.93
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.93
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.37
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PACE Senior Care Partners |
$65.48
|
| Rate for Payer: PACE SWMI |
$68.93
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: PHP Medicare Advantage |
$68.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO |
$239.87
|
| Rate for Payer: Priority Health Medicare |
$69.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.73
|
| Rate for Payer: Railroad Medicare Medicare |
$68.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.62
|
| Rate for Payer: UHC Core |
$230.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.93
|
| Rate for Payer: UHC Exchange |
$68.93
|
| Rate for Payer: UHC Medicare Advantage |
$68.93
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$68.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$41.51
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna Medicare |
$10.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.97
|
| Rate for Payer: BCBS Complete |
$4.23
|
| Rate for Payer: BCBS MAPPO |
$10.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.13
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$10.38
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.38
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Mclaren Medicaid |
$4.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.90
|
| Rate for Payer: Meridian Medicaid |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE Senior Care Partners |
$9.86
|
| Rate for Payer: PACE SWMI |
$10.38
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.81
|
| Rate for Payer: Railroad Medicare Medicare |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.53
|
| Rate for Payer: UHC Core |
$34.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.38
|
| Rate for Payer: UHC Exchange |
$10.38
|
| Rate for Payer: UHC Medicare Advantage |
$10.38
|
| Rate for Payer: UHCCP Medicaid |
$4.03
|
| Rate for Payer: VA VA |
$10.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
