|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$165.68 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: BCBS Trust/PPO |
$208.07
|
| Rate for Payer: BCN Commercial |
$196.99
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.68
|
| Rate for Payer: Priority Health HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC SARSCOV2 INF AB RSV AMP PRB
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600344
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$108.28
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$205.44
|
| Rate for Payer: BCN Commercial |
$194.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$103.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$108.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$63.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.43
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
| Rate for Payer: UHC Exchange |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$62.48
|
| Rate for Payer: UHCCP Medicaid |
$103.12
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC SARSCOV2 INF AB RSV AMP PRB
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600344
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: BCBS Trust/PPO |
$203.99
|
| Rate for Payer: BCN Commercial |
$193.12
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$219.13
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.04 |
| Max. Negotiated Rate |
$197.22 |
| Rate for Payer: Aetna Commercial |
$186.26
|
| Rate for Payer: Aetna Medicare |
$56.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.48
|
| Rate for Payer: BCBS Complete |
$87.65
|
| Rate for Payer: BCBS MAPPO |
$54.78
|
| Rate for Payer: BCBS Trust/PPO |
$180.15
|
| Rate for Payer: BCN Commercial |
$170.37
|
| Rate for Payer: BCN Medicare Advantage |
$54.78
|
| Rate for Payer: Cash Price |
$175.30
|
| Rate for Payer: Cofinity Commercial |
$188.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.78
|
| Rate for Payer: Healthscope Commercial |
$197.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.26
|
| Rate for Payer: Nomi Health Commercial |
$179.69
|
| Rate for Payer: PACE Senior Care Partners |
$52.04
|
| Rate for Payer: PACE SWMI |
$54.78
|
| Rate for Payer: PHP Commercial |
$186.26
|
| Rate for Payer: PHP Medicare Advantage |
$54.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.43
|
| Rate for Payer: Priority Health HMO/PPO |
$190.64
|
| Rate for Payer: Priority Health Medicare |
$55.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.82
|
| Rate for Payer: Railroad Medicare Medicare |
$54.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.83
|
| Rate for Payer: UHC Core |
$182.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.78
|
| Rate for Payer: UHC Exchange |
$54.78
|
| Rate for Payer: UHC Medicare Advantage |
$54.78
|
| Rate for Payer: VA VA |
$54.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.35
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$219.13
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$142.43 |
| Max. Negotiated Rate |
$197.22 |
| Rate for Payer: Aetna Commercial |
$186.26
|
| Rate for Payer: BCBS Trust/PPO |
$178.88
|
| Rate for Payer: BCN Commercial |
$169.34
|
| Rate for Payer: Cash Price |
$175.30
|
| Rate for Payer: Cofinity Commercial |
$188.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.30
|
| Rate for Payer: Healthscope Commercial |
$197.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.26
|
| Rate for Payer: Nomi Health Commercial |
$179.69
|
| Rate for Payer: PHP Commercial |
$186.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.43
|
| Rate for Payer: Priority Health HMO/PPO |
$190.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.83
|
| Rate for Payer: UHC Core |
$182.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.35
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$327.27
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$212.73 |
| Max. Negotiated Rate |
$294.54 |
| Rate for Payer: Aetna Commercial |
$278.18
|
| Rate for Payer: BCBS Trust/PPO |
$267.15
|
| Rate for Payer: BCN Commercial |
$252.91
|
| Rate for Payer: Cash Price |
$261.82
|
| Rate for Payer: Cofinity Commercial |
$281.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.82
|
| Rate for Payer: Healthscope Commercial |
$294.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.18
|
| Rate for Payer: Nomi Health Commercial |
$268.36
|
| Rate for Payer: PHP Commercial |
$278.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.73
|
| Rate for Payer: Priority Health HMO/PPO |
$284.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.00
|
| Rate for Payer: UHC Core |
$273.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.45
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$327.27
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$77.73 |
| Max. Negotiated Rate |
$294.54 |
| Rate for Payer: Aetna Commercial |
$278.18
|
| Rate for Payer: Aetna Medicare |
$85.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.27
|
| Rate for Payer: BCBS Complete |
$130.91
|
| Rate for Payer: BCBS MAPPO |
$81.82
|
| Rate for Payer: BCBS Trust/PPO |
$269.05
|
| Rate for Payer: BCN Commercial |
$254.45
|
| Rate for Payer: BCN Medicare Advantage |
$81.82
|
| Rate for Payer: Cash Price |
$261.82
|
| Rate for Payer: Cofinity Commercial |
$281.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.82
|
| Rate for Payer: Healthscope Commercial |
$294.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.18
|
| Rate for Payer: Nomi Health Commercial |
$268.36
|
| Rate for Payer: PACE Senior Care Partners |
$77.73
|
| Rate for Payer: PACE SWMI |
$81.82
|
| Rate for Payer: PHP Commercial |
$278.18
|
| Rate for Payer: PHP Medicare Advantage |
$81.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.73
|
| Rate for Payer: Priority Health HMO/PPO |
$284.72
|
| Rate for Payer: Priority Health Medicare |
$82.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.27
|
| Rate for Payer: Railroad Medicare Medicare |
$81.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.00
|
| Rate for Payer: UHC Core |
$273.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.82
|
| Rate for Payer: UHC Exchange |
$81.82
|
| Rate for Payer: UHC Medicare Advantage |
$81.82
|
| Rate for Payer: VA VA |
$81.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.45
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$163.65
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.87 |
| Max. Negotiated Rate |
$147.28 |
| Rate for Payer: Aetna Commercial |
$139.10
|
| Rate for Payer: Aetna Medicare |
$42.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.14
|
| Rate for Payer: BCBS Complete |
$65.46
|
| Rate for Payer: BCBS MAPPO |
$40.91
|
| Rate for Payer: BCBS Trust/PPO |
$134.54
|
| Rate for Payer: BCN Commercial |
$127.24
|
| Rate for Payer: BCN Medicare Advantage |
$40.91
|
| Rate for Payer: Cash Price |
$130.92
|
| Rate for Payer: Cofinity Commercial |
$140.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.91
|
| Rate for Payer: Healthscope Commercial |
$147.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.10
|
| Rate for Payer: Nomi Health Commercial |
$134.19
|
| Rate for Payer: PACE Senior Care Partners |
$38.87
|
| Rate for Payer: PACE SWMI |
$40.91
|
| Rate for Payer: PHP Commercial |
$139.10
|
| Rate for Payer: PHP Medicare Advantage |
$40.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.37
|
| Rate for Payer: Priority Health HMO/PPO |
$142.38
|
| Rate for Payer: Priority Health Medicare |
$41.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.65
|
| Rate for Payer: Railroad Medicare Medicare |
$40.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.01
|
| Rate for Payer: UHC Core |
$136.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.91
|
| Rate for Payer: UHC Exchange |
$40.91
|
| Rate for Payer: UHC Medicare Advantage |
$40.91
|
| Rate for Payer: VA VA |
$40.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.74
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$163.65
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$106.37 |
| Max. Negotiated Rate |
$147.28 |
| Rate for Payer: Aetna Commercial |
$139.10
|
| Rate for Payer: BCBS Trust/PPO |
$133.59
|
| Rate for Payer: BCN Commercial |
$126.47
|
| Rate for Payer: Cash Price |
$130.92
|
| Rate for Payer: Cofinity Commercial |
$140.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.92
|
| Rate for Payer: Healthscope Commercial |
$147.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.10
|
| Rate for Payer: Nomi Health Commercial |
$134.19
|
| Rate for Payer: PHP Commercial |
$139.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.37
|
| Rate for Payer: Priority Health HMO/PPO |
$142.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.01
|
| Rate for Payer: UHC Core |
$136.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.74
|
|
|
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: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: 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 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$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 Cigna Priority Health |
$0.01
|
| Rate for Payer: 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 Dual Complete DSNP |
$0.00
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SARSCOV AG
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
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 SARSCOV AG
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
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 |
$26.82
|
| 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 |
$25.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.82
|
| 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 |
$25.54
|
| 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 |
$25.54
|
| Rate for Payer: VA VA |
$15.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
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 SARSCOV CORONAVIRUS AG IA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
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 |
$26.82
|
| 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 |
$25.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.82
|
| 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 |
$25.54
|
| 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 |
$25.54
|
| Rate for Payer: VA VA |
$15.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC SARS FLU AB RSV
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$165.68 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: BCBS Trust/PPO |
$208.07
|
| Rate for Payer: BCN Commercial |
$196.99
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.68
|
| Rate for Payer: Priority Health HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC SARS FLU AB RSV
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$60.54 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.66
|
| Rate for Payer: BCBS Complete |
$108.28
|
| Rate for Payer: BCBS MAPPO |
$63.72
|
| Rate for Payer: BCBS Trust/PPO |
$209.55
|
| Rate for Payer: BCN Commercial |
$198.18
|
| Rate for Payer: BCN Medicare Advantage |
$63.72
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.72
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Mclaren Medicaid |
$103.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.91
|
| Rate for Payer: Meridian Medicaid |
$108.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: PACE Senior Care Partners |
$60.54
|
| Rate for Payer: PACE SWMI |
$63.72
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$63.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.68
|
| Rate for Payer: Priority Health HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Medicare |
$64.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.78
|
| Rate for Payer: Railroad Medicare Medicare |
$63.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.72
|
| Rate for Payer: UHC Exchange |
$63.72
|
| Rate for Payer: UHC Medicare Advantage |
$63.72
|
| Rate for Payer: UHCCP Medicaid |
$103.12
|
| Rate for Payer: VA VA |
$63.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC SCALLOP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
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 SCALLOP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
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 SCALP ELECTRODE
|
Facility
|
OP
|
$133.77
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$31.77 |
| Max. Negotiated Rate |
$120.39 |
| Rate for Payer: Aetna Commercial |
$113.70
|
| Rate for Payer: Aetna Medicare |
$34.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.80
|
| Rate for Payer: BCBS Complete |
$53.51
|
| Rate for Payer: BCBS MAPPO |
$33.44
|
| Rate for Payer: BCBS Trust/PPO |
$109.97
|
| Rate for Payer: BCN Commercial |
$104.01
|
| Rate for Payer: BCN Medicare Advantage |
$33.44
|
| Rate for Payer: Cash Price |
$107.02
|
| Rate for Payer: Cofinity Commercial |
$115.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.44
|
| Rate for Payer: Healthscope Commercial |
$120.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.70
|
| Rate for Payer: Nomi Health Commercial |
$109.69
|
| Rate for Payer: PACE Senior Care Partners |
$31.77
|
| Rate for Payer: PACE SWMI |
$33.44
|
| Rate for Payer: PHP Commercial |
$113.70
|
| Rate for Payer: PHP Medicare Advantage |
$33.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health HMO/PPO |
$116.38
|
| Rate for Payer: Priority Health Medicare |
$33.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.63
|
| Rate for Payer: Railroad Medicare Medicare |
$33.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.72
|
| Rate for Payer: UHC Core |
$111.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.44
|
| Rate for Payer: UHC Exchange |
$33.44
|
| Rate for Payer: UHC Medicare Advantage |
$33.44
|
| Rate for Payer: VA VA |
$33.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.33
|
|
|
HC SCALP ELECTRODE
|
Facility
|
IP
|
$133.77
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$86.95 |
| Max. Negotiated Rate |
$120.39 |
| Rate for Payer: Aetna Commercial |
$113.70
|
| Rate for Payer: BCBS Trust/PPO |
$109.20
|
| Rate for Payer: BCN Commercial |
$103.38
|
| Rate for Payer: Cash Price |
$107.02
|
| Rate for Payer: Cofinity Commercial |
$115.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.02
|
| Rate for Payer: Healthscope Commercial |
$120.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.70
|
| Rate for Payer: Nomi Health Commercial |
$109.69
|
| Rate for Payer: PHP Commercial |
$113.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health HMO/PPO |
$116.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.72
|
| Rate for Payer: UHC Core |
$111.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.33
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$99.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.84 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: BCBS Trust/PPO |
$81.43
|
| Rate for Payer: BCN Commercial |
$77.09
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: Priority Health HMO/PPO |
$86.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.79
|
| Rate for Payer: UHC Core |
$83.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.82
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$99.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.41 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna Medicare |
$25.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.18
|
| Rate for Payer: BCBS Complete |
$9.88
|
| Rate for Payer: BCBS MAPPO |
$24.94
|
| Rate for Payer: BCBS Trust/PPO |
$82.01
|
| Rate for Payer: BCN Commercial |
$77.56
|
| Rate for Payer: BCN Medicare Advantage |
$24.94
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.94
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.82
|
| Rate for Payer: Mclaren Medicaid |
$9.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.19
|
| Rate for Payer: Meridian Medicaid |
$9.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: PACE Senior Care Partners |
$23.69
|
| Rate for Payer: PACE SWMI |
$24.94
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: PHP Medicare Advantage |
$24.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: Priority Health HMO/PPO |
$86.79
|
| Rate for Payer: Priority Health Medicare |
$25.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.84
|
| Rate for Payer: Railroad Medicare Medicare |
$24.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.79
|
| Rate for Payer: UHC Core |
$83.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.94
|
| Rate for Payer: UHC Exchange |
$24.94
|
| Rate for Payer: UHC Medicare Advantage |
$24.94
|
| Rate for Payer: UHCCP Medicaid |
$9.41
|
| Rate for Payer: VA VA |
$24.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.82
|
|
|
HC SCISSORS
|
Facility
|
IP
|
$17.67
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$15.90 |
| Rate for Payer: Aetna Commercial |
$15.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.42
|
| Rate for Payer: BCN Commercial |
$13.66
|
| Rate for Payer: Cash Price |
$14.14
|
| Rate for Payer: Cofinity Commercial |
$15.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$15.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.02
|
| Rate for Payer: Nomi Health Commercial |
$14.49
|
| Rate for Payer: PHP Commercial |
$15.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.49
|
| Rate for Payer: Priority Health HMO/PPO |
$15.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.55
|
| Rate for Payer: UHC Core |
$14.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.25
|
|
|
HC SCISSORS
|
Facility
|
OP
|
$17.67
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$15.90 |
| Rate for Payer: Aetna Commercial |
$15.02
|
| Rate for Payer: Aetna Medicare |
$4.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.52
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$4.42
|
| Rate for Payer: BCBS Trust/PPO |
$14.53
|
| Rate for Payer: BCN Commercial |
$13.74
|
| Rate for Payer: BCN Medicare Advantage |
$4.42
|
| Rate for Payer: Cash Price |
$14.14
|
| Rate for Payer: Cofinity Commercial |
$15.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.42
|
| Rate for Payer: Healthscope Commercial |
$15.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.02
|
| Rate for Payer: Nomi Health Commercial |
$14.49
|
| Rate for Payer: PACE Senior Care Partners |
$4.20
|
| Rate for Payer: PACE SWMI |
$4.42
|
| Rate for Payer: PHP Commercial |
$15.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.49
|
| Rate for Payer: Priority Health HMO/PPO |
$15.37
|
| Rate for Payer: Priority Health Medicare |
$4.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.84
|
| Rate for Payer: Railroad Medicare Medicare |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.55
|
| Rate for Payer: UHC Core |
$14.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Medicare Advantage |
$4.42
|
| Rate for Payer: VA VA |
$4.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.25
|
|
