|
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 |
$46.81
|
| 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 |
$46.81
|
|
|
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 |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| 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 |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| 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 |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| 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 |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$25.54
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
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 |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| 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 |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| 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 |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| 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 |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$25.54
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
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 |
$46.81
|
| 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 |
$46.81
|
|
|
HC SARS FLU AB RSV
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$165.69 |
| 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 |
$165.69
|
| 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 |
$101.96
|
| Rate for Payer: BCBS MAPPO |
$63.73
|
| Rate for Payer: BCBS Trust/PPO |
$209.55
|
| Rate for Payer: BCN Commercial |
$198.18
|
| Rate for Payer: BCN Medicare Advantage |
$63.73
|
| 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 |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.91
|
| 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 |
$63.73
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$63.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.69
|
| 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 |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.73
|
| Rate for Payer: UHC Exchange |
$63.73
|
| Rate for Payer: UHC Medicare Advantage |
$63.73
|
| Rate for Payer: VA VA |
$63.73
|
| 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
|
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
|
|
|
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 SCL70 SCLERODERMA AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$605.74 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna Medicare |
$663.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.02
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$637.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,096.75
|
| Rate for Payer: BCN Commercial |
$1,983.00
|
| Rate for Payer: BCN Medicare Advantage |
$637.62
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.62
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.50
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: PACE Senior Care Partners |
$605.74
|
| Rate for Payer: PACE SWMI |
$637.62
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: PHP Medicare Advantage |
$637.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.81
|
| Rate for Payer: Priority Health HMO/PPO |
$2,218.92
|
| Rate for Payer: Priority Health Medicare |
$644.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,708.82
|
| Rate for Payer: Railroad Medicare Medicare |
$637.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.42
|
| Rate for Payer: UHC Core |
$2,129.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.62
|
| Rate for Payer: UHC Exchange |
$637.62
|
| Rate for Payer: UHC Medicare Advantage |
$637.62
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$637.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,657.81 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,081.96
|
| Rate for Payer: BCN Commercial |
$1,971.01
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.81
|
| Rate for Payer: Priority Health HMO/PPO |
$2,218.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,708.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.42
|
| Rate for Payer: UHC Core |
$2,129.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$51.08 |
| Max. Negotiated Rate |
$70.73 |
| Rate for Payer: Aetna Commercial |
$66.80
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.73
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$67.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Healthscope Commercial |
$70.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: PHP Commercial |
$66.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health HMO/PPO |
$68.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.16
|
| Rate for Payer: UHC Core |
$65.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.94
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$17.71 |
| Max. Negotiated Rate |
$70.73 |
| Rate for Payer: Aetna Commercial |
$66.80
|
| Rate for Payer: Aetna Medicare |
$20.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.56
|
| Rate for Payer: BCBS Complete |
$18.59
|
| Rate for Payer: BCBS MAPPO |
$19.65
|
| Rate for Payer: BCBS Trust/PPO |
$64.61
|
| Rate for Payer: BCN Commercial |
$61.10
|
| Rate for Payer: BCN Medicare Advantage |
$19.65
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$67.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$70.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.94
|
| Rate for Payer: Mclaren Medicaid |
$17.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.63
|
| Rate for Payer: Meridian Medicaid |
$18.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: PACE Senior Care Partners |
$18.67
|
| Rate for Payer: PACE SWMI |
$19.65
|
| Rate for Payer: PHP Commercial |
$66.80
|
| Rate for Payer: PHP Medicare Advantage |
$19.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health HMO/PPO |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$19.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.16
|
| Rate for Payer: UHC Core |
$65.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.65
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicare Advantage |
$19.65
|
| Rate for Payer: UHCCP Medicaid |
$17.71
|
| Rate for Payer: VA VA |
$19.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.94
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$24.51 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Aetna Commercial |
$87.73
|
| Rate for Payer: Aetna Medicare |
$26.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.25
|
| Rate for Payer: BCBS Complete |
$41.28
|
| Rate for Payer: BCBS MAPPO |
$25.80
|
| Rate for Payer: BCBS Trust/PPO |
$84.85
|
| Rate for Payer: BCN Commercial |
$80.25
|
| Rate for Payer: BCN Medicare Advantage |
$25.80
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$92.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: PACE Senior Care Partners |
$24.51
|
| Rate for Payer: PACE SWMI |
$25.80
|
| Rate for Payer: PHP Commercial |
$87.73
|
| Rate for Payer: PHP Medicare Advantage |
$25.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO |
$89.79
|
| Rate for Payer: Priority Health Medicare |
$26.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.15
|
| Rate for Payer: Railroad Medicare Medicare |
$25.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.82
|
| Rate for Payer: UHC Core |
$86.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.80
|
| Rate for Payer: UHC Exchange |
$25.80
|
| Rate for Payer: UHC Medicare Advantage |
$25.80
|
| Rate for Payer: VA VA |
$25.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Aetna Commercial |
$87.73
|
| Rate for Payer: BCBS Trust/PPO |
$84.25
|
| Rate for Payer: BCN Commercial |
$79.76
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$92.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: PHP Commercial |
$87.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO |
$89.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.82
|
| Rate for Payer: UHC Core |
$86.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,671.92 |
| Max. Negotiated Rate |
$2,314.97 |
| Rate for Payer: Aetna Commercial |
$2,186.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,099.68
|
| Rate for Payer: BCN Commercial |
$1,987.79
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$2,212.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Healthscope Commercial |
$2,314.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$2,109.20
|
| Rate for Payer: PHP Commercial |
$2,186.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health HMO/PPO |
$2,237.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,723.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,263.53
|
| Rate for Payer: UHC Core |
$2,147.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.14
|
|
