|
HC RPR (SYPHILIS SEROLOGY) SERUM
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200213
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RPR (SYPHILIS SEROLOGY) SERUM
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200213
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RPR TITER
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200425
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$3.18
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RPR TITER
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200425
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RSV DNA/RNA AMP PROBE
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
30600315
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$53.30
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$50.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$53.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$50.75
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC RSV DNA/RNA AMP PROBE
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
30600315
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 0.5ML IM
|
Facility
|
OP
|
$1,302.54
|
|
|
Service Code
|
CPT 90380
|
| Hospital Charge Code |
63600232
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$309.35 |
| Max. Negotiated Rate |
$1,172.29 |
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: Aetna Medicare |
$338.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$407.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$407.04
|
| Rate for Payer: BCBS Complete |
$521.02
|
| Rate for Payer: BCBS MAPPO |
$325.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,070.82
|
| Rate for Payer: BCN Commercial |
$1,012.72
|
| Rate for Payer: BCN Medicare Advantage |
$325.63
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.63
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: Nomi Health Commercial |
$1,068.08
|
| Rate for Payer: PACE Senior Care Partners |
$309.35
|
| Rate for Payer: PACE SWMI |
$325.63
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: PHP Medicare Advantage |
$325.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,133.21
|
| Rate for Payer: Priority Health Medicare |
$328.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.70
|
| Rate for Payer: Railroad Medicare Medicare |
$325.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.24
|
| Rate for Payer: UHC Core |
$1,087.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$325.63
|
| Rate for Payer: UHC Exchange |
$325.63
|
| Rate for Payer: UHC Medicare Advantage |
$325.63
|
| Rate for Payer: VA VA |
$325.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 0.5ML IM
|
Facility
|
IP
|
$1,302.54
|
|
|
Service Code
|
CPT 90380
|
| Hospital Charge Code |
63600232
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$846.65 |
| Max. Negotiated Rate |
$1,172.29 |
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,063.26
|
| Rate for Payer: BCN Commercial |
$1,006.60
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: Nomi Health Commercial |
$1,068.08
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,133.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.24
|
| Rate for Payer: UHC Core |
$1,087.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 1 ML IM
|
Facility
|
OP
|
$1,302.54
|
|
|
Service Code
|
CPT 90381
|
| Hospital Charge Code |
63600233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$309.35 |
| Max. Negotiated Rate |
$1,172.29 |
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: Aetna Medicare |
$338.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$407.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$407.04
|
| Rate for Payer: BCBS Complete |
$521.02
|
| Rate for Payer: BCBS MAPPO |
$325.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,070.82
|
| Rate for Payer: BCN Commercial |
$1,012.72
|
| Rate for Payer: BCN Medicare Advantage |
$325.63
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.63
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: Nomi Health Commercial |
$1,068.08
|
| Rate for Payer: PACE Senior Care Partners |
$309.35
|
| Rate for Payer: PACE SWMI |
$325.63
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: PHP Medicare Advantage |
$325.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,133.21
|
| Rate for Payer: Priority Health Medicare |
$328.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.70
|
| Rate for Payer: Railroad Medicare Medicare |
$325.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.24
|
| Rate for Payer: UHC Core |
$1,087.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$325.63
|
| Rate for Payer: UHC Exchange |
$325.63
|
| Rate for Payer: UHC Medicare Advantage |
$325.63
|
| Rate for Payer: VA VA |
$325.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 1 ML IM
|
Facility
|
IP
|
$1,302.54
|
|
|
Service Code
|
CPT 90381
|
| Hospital Charge Code |
63600233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$846.65 |
| Max. Negotiated Rate |
$1,172.29 |
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,063.26
|
| Rate for Payer: BCN Commercial |
$1,006.60
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: Nomi Health Commercial |
$1,068.08
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,133.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.24
|
| Rate for Payer: UHC Core |
$1,087.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RT ANGLE BALL COR CANN
|
Facility
|
OP
|
$70.69
|
|
| Hospital Charge Code |
27000268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.79 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: Aetna Medicare |
$18.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.09
|
| Rate for Payer: BCBS Complete |
$28.28
|
| Rate for Payer: BCBS MAPPO |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$54.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.67
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.67
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.09
|
| Rate for Payer: Nomi Health Commercial |
$57.97
|
| Rate for Payer: PACE Senior Care Partners |
$16.79
|
| Rate for Payer: PACE SWMI |
$17.67
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health HMO/PPO |
$61.50
|
| Rate for Payer: Priority Health Medicare |
$17.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.36
|
| Rate for Payer: Railroad Medicare Medicare |
$17.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.21
|
| Rate for Payer: UHC Core |
$59.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.67
|
| Rate for Payer: UHC Exchange |
$17.67
|
| Rate for Payer: UHC Medicare Advantage |
$17.67
|
| Rate for Payer: VA VA |
$17.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC RT ANGLE BALL COR CANN
|
Facility
|
IP
|
$70.69
|
|
| Hospital Charge Code |
27000268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.95 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: BCBS Trust/PPO |
$57.70
|
| Rate for Payer: BCN Commercial |
$54.63
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.09
|
| Rate for Payer: Nomi Health Commercial |
$57.97
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health HMO/PPO |
$61.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.21
|
| Rate for Payer: UHC Core |
$59.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC RUBELLA ANTIBODY IGC
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC RUBELLA ANTIBODY IGC
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
IP
|
$87.82
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: BCBS Trust/PPO |
$71.69
|
| Rate for Payer: BCN Commercial |
$67.87
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO |
$76.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.28
|
| Rate for Payer: UHC Core |
$73.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.86
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
OP
|
$87.82
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna Medicare |
$22.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.44
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$21.95
|
| Rate for Payer: BCBS Trust/PPO |
$72.20
|
| Rate for Payer: BCN Commercial |
$68.28
|
| Rate for Payer: BCN Medicare Advantage |
$21.95
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.95
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.86
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.05
|
| Rate for Payer: Meridian Medicaid |
$9.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: PACE Senior Care Partners |
$20.86
|
| Rate for Payer: PACE SWMI |
$21.95
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO |
$76.40
|
| Rate for Payer: Priority Health Medicare |
$22.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.84
|
| Rate for Payer: Railroad Medicare Medicare |
$21.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.28
|
| Rate for Payer: UHC Core |
$73.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.95
|
| Rate for Payer: UHC Exchange |
$21.95
|
| Rate for Payer: UHC Medicare Advantage |
$21.95
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.86
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$486.88 |
| Max. Negotiated Rate |
$1,845.00 |
| Rate for Payer: Aetna Commercial |
$1,742.50
|
| Rate for Payer: Aetna Medicare |
$533.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$640.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$640.62
|
| Rate for Payer: BCBS Complete |
$820.00
|
| Rate for Payer: BCBS MAPPO |
$512.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.31
|
| Rate for Payer: BCN Commercial |
$1,593.88
|
| Rate for Payer: BCN Medicare Advantage |
$512.50
|
| Rate for Payer: Cash Price |
$1,640.00
|
| Rate for Payer: Cofinity Commercial |
$1,763.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.50
|
| Rate for Payer: Healthscope Commercial |
$1,845.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$589.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,742.50
|
| Rate for Payer: Nomi Health Commercial |
$1,681.00
|
| Rate for Payer: PACE Senior Care Partners |
$486.88
|
| Rate for Payer: PACE SWMI |
$512.50
|
| Rate for Payer: PHP Commercial |
$1,742.50
|
| Rate for Payer: PHP Medicare Advantage |
$512.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,783.50
|
| Rate for Payer: Priority Health Medicare |
$517.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.50
|
| Rate for Payer: Railroad Medicare Medicare |
$512.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.00
|
| Rate for Payer: UHC Core |
$1,711.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.50
|
| Rate for Payer: UHC Exchange |
$512.50
|
| Rate for Payer: UHC Medicare Advantage |
$512.50
|
| Rate for Payer: VA VA |
$512.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.50
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,332.50 |
| Max. Negotiated Rate |
$1,845.00 |
| Rate for Payer: Aetna Commercial |
$1,742.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.41
|
| Rate for Payer: BCN Commercial |
$1,584.24
|
| Rate for Payer: Cash Price |
$1,640.00
|
| Rate for Payer: Cofinity Commercial |
$1,763.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.00
|
| Rate for Payer: Healthscope Commercial |
$1,845.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,742.50
|
| Rate for Payer: Nomi Health Commercial |
$1,681.00
|
| Rate for Payer: PHP Commercial |
$1,742.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,783.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.00
|
| Rate for Payer: UHC Core |
$1,711.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.50
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
IP
|
$61.61
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.05 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: BCBS Trust/PPO |
$50.29
|
| Rate for Payer: BCN Commercial |
$47.61
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO |
$53.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.22
|
| Rate for Payer: UHC Core |
$51.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.21
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
OP
|
$61.61
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.25
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$15.40
|
| Rate for Payer: BCBS Trust/PPO |
$50.65
|
| Rate for Payer: BCN Commercial |
$47.90
|
| Rate for Payer: BCN Medicare Advantage |
$15.40
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.40
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.21
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.17
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PACE Senior Care Partners |
$14.63
|
| Rate for Payer: PACE SWMI |
$15.40
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: PHP Medicare Advantage |
$15.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO |
$53.60
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.28
|
| Rate for Payer: Railroad Medicare Medicare |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.22
|
| Rate for Payer: UHC Core |
$51.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.40
|
| Rate for Payer: UHC Exchange |
$15.40
|
| Rate for Payer: UHC Medicare Advantage |
$15.40
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.21
|
|
|
HC RUSSIAN THISTLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RUSSIAN THISTLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
OP
|
$1,352.52
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.22 |
| Max. Negotiated Rate |
$1,217.27 |
| Rate for Payer: Aetna Commercial |
$1,149.64
|
| Rate for Payer: Aetna Medicare |
$351.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$422.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$422.66
|
| Rate for Payer: BCBS Complete |
$541.01
|
| Rate for Payer: BCBS MAPPO |
$338.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,111.91
|
| Rate for Payer: BCN Commercial |
$1,051.58
|
| Rate for Payer: BCN Medicare Advantage |
$338.13
|
| Rate for Payer: Cash Price |
$1,082.02
|
| Rate for Payer: Cofinity Commercial |
$1,163.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.13
|
| Rate for Payer: Healthscope Commercial |
$1,217.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$388.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,149.64
|
| Rate for Payer: Nomi Health Commercial |
$1,109.07
|
| Rate for Payer: PACE Senior Care Partners |
$321.22
|
| Rate for Payer: PACE SWMI |
$338.13
|
| Rate for Payer: PHP Commercial |
$1,149.64
|
| Rate for Payer: PHP Medicare Advantage |
$338.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.14
|
| Rate for Payer: Priority Health HMO/PPO |
$1,176.69
|
| Rate for Payer: Priority Health Medicare |
$341.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$906.19
|
| Rate for Payer: Railroad Medicare Medicare |
$338.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.22
|
| Rate for Payer: UHC Core |
$1,129.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.13
|
| Rate for Payer: UHC Exchange |
$338.13
|
| Rate for Payer: UHC Medicare Advantage |
$338.13
|
| Rate for Payer: VA VA |
$338.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.39
|
|
