|
HC VAP CHOLESTEROL
|
Facility
|
OP
|
$84.89
|
|
|
Service Code
|
CPT 83701
|
| Hospital Charge Code |
30100281
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.97 |
| Max. Negotiated Rate |
$76.40 |
| Rate for Payer: Aetna Commercial |
$72.16
|
| Rate for Payer: Aetna Medicare |
$22.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.53
|
| Rate for Payer: BCBS Complete |
$15.71
|
| Rate for Payer: BCBS MAPPO |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$69.79
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: BCN Medicare Advantage |
$21.22
|
| Rate for Payer: Cash Price |
$67.91
|
| Rate for Payer: Cofinity Commercial |
$73.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$76.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$14.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.28
|
| Rate for Payer: Meridian Medicaid |
$15.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.16
|
| Rate for Payer: Nomi Health Commercial |
$69.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.67
|
| Rate for Payer: PACE Senior Care Partners |
$20.16
|
| Rate for Payer: PACE SWMI |
$21.22
|
| Rate for Payer: PHP Commercial |
$72.16
|
| Rate for Payer: PHP Medicare Advantage |
$21.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.85
|
| Rate for Payer: Priority Health Medicare |
$21.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.08
|
| Rate for Payer: Railroad Medicare Medicare |
$21.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.70
|
| Rate for Payer: UHC Core |
$70.88
|
| Rate for Payer: UHC Exchange |
$21.22
|
| Rate for Payer: UHC Medicaid |
$14.97
|
| Rate for Payer: UHC Medicare Advantage |
$21.22
|
| Rate for Payer: UHCCP Medicaid |
$14.97
|
| Rate for Payer: VA VA |
$21.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.67
|
|
|
HC VAP CHOLESTEROL CMPT
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100445
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC VAP CHOLESTEROL CMPT
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100445
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC VARICELLA VIRUS VACCINE (VAR), LIVE SUBQ
|
Facility
|
IP
|
$224.97
|
|
|
Service Code
|
CPT 90716
|
| Hospital Charge Code |
63600084
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$156.58 |
| Max. Negotiated Rate |
$202.47 |
| Rate for Payer: Aetna Commercial |
$191.22
|
| Rate for Payer: BCBS Trust/PPO |
$185.80
|
| Rate for Payer: BCN Commercial |
$185.80
|
| Rate for Payer: Cash Price |
$179.98
|
| Rate for Payer: Cofinity Commercial |
$193.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.98
|
| Rate for Payer: Healthscope Commercial |
$202.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.22
|
| Rate for Payer: Nomi Health Commercial |
$184.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.73
|
| Rate for Payer: PHP Commercial |
$191.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.97
|
| Rate for Payer: UHC Core |
$187.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.73
|
|
|
HC VARICELLA VIRUS VACCINE (VAR), LIVE SUBQ
|
Facility
|
OP
|
$224.97
|
|
|
Service Code
|
CPT 90716
|
| Hospital Charge Code |
63600084
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.66 |
| Max. Negotiated Rate |
$202.47 |
| Rate for Payer: Aetna Commercial |
$191.22
|
| Rate for Payer: Aetna Medicare |
$58.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.30
|
| Rate for Payer: BCBS Complete |
$41.64
|
| Rate for Payer: BCBS MAPPO |
$56.24
|
| Rate for Payer: BCBS Trust/PPO |
$184.95
|
| Rate for Payer: BCN Commercial |
$184.95
|
| Rate for Payer: BCN Medicare Advantage |
$56.24
|
| Rate for Payer: Cash Price |
$179.98
|
| Rate for Payer: Cofinity Commercial |
$193.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.24
|
| Rate for Payer: Healthscope Commercial |
$202.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.73
|
| Rate for Payer: Mclaren Medicaid |
$39.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.05
|
| Rate for Payer: Meridian Medicaid |
$41.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.22
|
| Rate for Payer: Nomi Health Commercial |
$184.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.73
|
| Rate for Payer: PACE Senior Care Partners |
$53.43
|
| Rate for Payer: PACE SWMI |
$56.24
|
| Rate for Payer: PHP Commercial |
$191.22
|
| Rate for Payer: PHP Medicare Advantage |
$56.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.72
|
| Rate for Payer: Priority Health Medicare |
$56.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.58
|
| Rate for Payer: Railroad Medicare Medicare |
$56.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.97
|
| Rate for Payer: UHC Core |
$187.85
|
| Rate for Payer: UHC Exchange |
$56.24
|
| Rate for Payer: UHC Medicaid |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$56.24
|
| Rate for Payer: UHCCP Medicaid |
$39.66
|
| Rate for Payer: VA VA |
$56.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.73
|
|
|
HC VARICELLA ZOSTER IGG
|
Facility
|
OP
|
$45.63
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200327
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: Aetna Medicare |
$11.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.26
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS MAPPO |
$11.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.51
|
| Rate for Payer: BCN Commercial |
$37.51
|
| Rate for Payer: BCN Medicare Advantage |
$11.41
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Mclaren Medicaid |
$8.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$8.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PACE Senior Care Partners |
$10.84
|
| Rate for Payer: PACE SWMI |
$11.41
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: PHP Medicare Advantage |
$11.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Medicare |
$11.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: UHC Exchange |
$11.41
|
| Rate for Payer: UHC Medicaid |
$8.04
|
| Rate for Payer: UHC Medicare Advantage |
$11.41
|
| Rate for Payer: UHCCP Medicaid |
$8.04
|
| Rate for Payer: VA VA |
$11.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC VARICELLA ZOSTER IGG
|
Facility
|
IP
|
$45.63
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200327
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: BCBS Trust/PPO |
$37.69
|
| Rate for Payer: BCN Commercial |
$37.69
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC VARICELLA ZOSTER IGM
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200326
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: BCBS Trust/PPO |
$67.88
|
| Rate for Payer: BCN Commercial |
$67.88
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC VARICELLA ZOSTER IGM
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200326
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$21.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.68
|
| Rate for Payer: BCBS Complete |
$15.21
|
| Rate for Payer: BCBS MAPPO |
$20.55
|
| Rate for Payer: BCBS Trust/PPO |
$67.57
|
| Rate for Payer: BCN Commercial |
$67.57
|
| Rate for Payer: BCN Medicare Advantage |
$20.55
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.55
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.57
|
| Rate for Payer: Meridian Medicaid |
$15.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Senior Care Partners |
$19.52
|
| Rate for Payer: PACE SWMI |
$20.55
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$20.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.20
|
| Rate for Payer: Railroad Medicare Medicare |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: UHC Exchange |
$20.55
|
| Rate for Payer: UHC Medicaid |
$14.49
|
| Rate for Payer: UHC Medicare Advantage |
$20.55
|
| Rate for Payer: UHCCP Medicaid |
$14.49
|
| Rate for Payer: VA VA |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC VARICELLA ZOSTER PCR CSF
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600167
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.64 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.82
|
| Rate for Payer: BCBS Complete |
$20.62
|
| Rate for Payer: BCBS MAPPO |
$27.86
|
| Rate for Payer: BCBS Trust/PPO |
$91.60
|
| Rate for Payer: BCN Commercial |
$91.60
|
| Rate for Payer: BCN Medicare Advantage |
$27.86
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.86
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Mclaren Medicaid |
$19.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.25
|
| Rate for Payer: Meridian Medicaid |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Senior Care Partners |
$26.46
|
| Rate for Payer: PACE SWMI |
$27.86
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: PHP Medicare Advantage |
$27.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Medicare |
$28.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: Railroad Medicare Medicare |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: UHC Exchange |
$27.86
|
| Rate for Payer: UHC Medicaid |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$27.86
|
| Rate for Payer: UHCCP Medicaid |
$19.64
|
| Rate for Payer: VA VA |
$27.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC VARICELLA ZOSTER PCR CSF
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600167
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$92.02
|
| Rate for Payer: BCN Commercial |
$92.02
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC VARICELLA ZOSTER VIRUS (VZV)
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600278
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC VARICELLA ZOSTER VIRUS (VZV)
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600278
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$51.88
|
| Rate for Payer: BCN Commercial |
$51.88
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC VASCLAR EMBO OR OCCLUS DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$208.50
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
36100533
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.12 |
| Max. Negotiated Rate |
$187.65 |
| Rate for Payer: Aetna Commercial |
$177.22
|
| Rate for Payer: BCBS Trust/PPO |
$172.20
|
| Rate for Payer: BCN Commercial |
$172.20
|
| Rate for Payer: Cash Price |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$179.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.80
|
| Rate for Payer: Healthscope Commercial |
$187.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.22
|
| Rate for Payer: Nomi Health Commercial |
$170.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.38
|
| Rate for Payer: PHP Commercial |
$177.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.48
|
| Rate for Payer: UHC Core |
$174.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.38
|
|
|
HC VASCLAR EMBO OR OCCLUS DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$208.50
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
36100533
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$36.76 |
| Max. Negotiated Rate |
$187.65 |
| Rate for Payer: Aetna Commercial |
$177.22
|
| Rate for Payer: Aetna Medicare |
$54.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.16
|
| Rate for Payer: BCBS Complete |
$38.59
|
| Rate for Payer: BCBS MAPPO |
$52.12
|
| Rate for Payer: BCBS Trust/PPO |
$171.41
|
| Rate for Payer: BCN Commercial |
$171.41
|
| Rate for Payer: BCN Medicare Advantage |
$52.12
|
| Rate for Payer: Cash Price |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$179.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.12
|
| Rate for Payer: Healthscope Commercial |
$187.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.38
|
| Rate for Payer: Mclaren Medicaid |
$36.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.73
|
| Rate for Payer: Meridian Medicaid |
$38.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.22
|
| Rate for Payer: Nomi Health Commercial |
$170.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.38
|
| Rate for Payer: PACE Senior Care Partners |
$49.52
|
| Rate for Payer: PACE SWMI |
$52.12
|
| Rate for Payer: PHP Commercial |
$177.22
|
| Rate for Payer: PHP Medicare Advantage |
$52.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.40
|
| Rate for Payer: Priority Health Medicare |
$52.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$52.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.48
|
| Rate for Payer: UHC Core |
$174.10
|
| Rate for Payer: UHC Exchange |
$52.12
|
| Rate for Payer: UHC Medicaid |
$36.76
|
| Rate for Payer: UHC Medicare Advantage |
$52.12
|
| Rate for Payer: UHCCP Medicaid |
$36.76
|
| Rate for Payer: VA VA |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.38
|
|
|
HC VASCULAR EMBOL/OCCLU W PRESSURE GEN CATH
|
Facility
|
IP
|
$34,088.40
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
36100635
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$23,725.53 |
| Max. Negotiated Rate |
$30,679.56 |
| Rate for Payer: Aetna Commercial |
$28,975.14
|
| Rate for Payer: BCBS Trust/PPO |
$28,153.61
|
| Rate for Payer: BCN Commercial |
$28,153.61
|
| Rate for Payer: Cash Price |
$27,270.72
|
| Rate for Payer: Cofinity Commercial |
$29,316.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27,270.72
|
| Rate for Payer: Healthscope Commercial |
$30,679.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25,566.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,975.14
|
| Rate for Payer: Nomi Health Commercial |
$27,952.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25,566.30
|
| Rate for Payer: PHP Commercial |
$28,975.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29,656.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23,725.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,997.79
|
| Rate for Payer: UHC Core |
$28,463.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25,566.30
|
|
|
HC VASCULAR EMBOL/OCCLU W PRESSURE GEN CATH
|
Facility
|
OP
|
$34,088.40
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
36100635
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,009.78 |
| Max. Negotiated Rate |
$30,679.56 |
| Rate for Payer: Aetna Commercial |
$28,975.14
|
| Rate for Payer: Aetna Medicare |
$8,862.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,652.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,652.62
|
| Rate for Payer: BCBS Complete |
$6,309.76
|
| Rate for Payer: BCBS MAPPO |
$8,522.10
|
| Rate for Payer: BCBS Trust/PPO |
$28,024.07
|
| Rate for Payer: BCN Commercial |
$28,024.07
|
| Rate for Payer: BCN Medicare Advantage |
$8,522.10
|
| Rate for Payer: Cash Price |
$27,270.72
|
| Rate for Payer: Cofinity Commercial |
$29,316.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27,270.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,522.10
|
| Rate for Payer: Healthscope Commercial |
$30,679.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25,566.30
|
| Rate for Payer: Mclaren Medicaid |
$6,009.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,948.20
|
| Rate for Payer: Meridian Medicaid |
$6,309.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,800.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,374.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,975.14
|
| Rate for Payer: Nomi Health Commercial |
$27,952.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25,566.30
|
| Rate for Payer: PACE Senior Care Partners |
$8,095.99
|
| Rate for Payer: PACE SWMI |
$8,522.10
|
| Rate for Payer: PHP Commercial |
$28,975.14
|
| Rate for Payer: PHP Medicare Advantage |
$8,522.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,009.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29,656.91
|
| Rate for Payer: Priority Health Medicare |
$8,607.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23,725.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8,522.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,997.79
|
| Rate for Payer: UHC Core |
$28,463.81
|
| Rate for Payer: UHC Exchange |
$8,522.10
|
| Rate for Payer: UHC Medicaid |
$6,009.78
|
| Rate for Payer: UHC Medicare Advantage |
$8,522.10
|
| Rate for Payer: UHCCP Medicaid |
$6,009.78
|
| Rate for Payer: VA VA |
$8,522.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25,566.30
|
|
|
HC VASCULAR GRAFT
|
Facility
|
OP
|
$2,360.69
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27800033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.19 |
| Max. Negotiated Rate |
$2,124.62 |
| Rate for Payer: Aetna Commercial |
$2,006.59
|
| Rate for Payer: Aetna Medicare |
$613.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$737.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$737.72
|
| Rate for Payer: BCBS Complete |
$436.96
|
| Rate for Payer: BCBS MAPPO |
$590.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.72
|
| Rate for Payer: BCN Commercial |
$1,940.72
|
| Rate for Payer: BCN Medicare Advantage |
$590.17
|
| Rate for Payer: Cash Price |
$1,888.55
|
| Rate for Payer: Cofinity Commercial |
$2,030.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,888.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.17
|
| Rate for Payer: Healthscope Commercial |
$2,124.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,770.52
|
| Rate for Payer: Mclaren Medicaid |
$416.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.68
|
| Rate for Payer: Meridian Medicaid |
$436.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$678.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$649.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.59
|
| Rate for Payer: Nomi Health Commercial |
$1,935.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,770.52
|
| Rate for Payer: PACE Senior Care Partners |
$560.66
|
| Rate for Payer: PACE SWMI |
$590.17
|
| Rate for Payer: PHP Commercial |
$2,006.59
|
| Rate for Payer: PHP Medicare Advantage |
$590.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,053.80
|
| Rate for Payer: Priority Health Medicare |
$596.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,643.04
|
| Rate for Payer: Railroad Medicare Medicare |
$590.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,077.41
|
| Rate for Payer: UHC Core |
$1,971.18
|
| Rate for Payer: UHC Exchange |
$590.17
|
| Rate for Payer: UHC Medicaid |
$416.19
|
| Rate for Payer: UHC Medicare Advantage |
$590.17
|
| Rate for Payer: UHCCP Medicaid |
$416.19
|
| Rate for Payer: VA VA |
$590.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,770.52
|
|
|
HC VASCULAR GRAFT
|
Facility
|
IP
|
$2,360.69
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27800033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,643.04 |
| Max. Negotiated Rate |
$2,124.62 |
| Rate for Payer: Aetna Commercial |
$2,006.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.69
|
| Rate for Payer: BCN Commercial |
$1,949.69
|
| Rate for Payer: Cash Price |
$1,888.55
|
| Rate for Payer: Cofinity Commercial |
$2,030.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,888.55
|
| Rate for Payer: Healthscope Commercial |
$2,124.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,770.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.59
|
| Rate for Payer: Nomi Health Commercial |
$1,935.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,770.52
|
| Rate for Payer: PHP Commercial |
$2,006.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,053.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,643.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,077.41
|
| Rate for Payer: UHC Core |
$1,971.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,770.52
|
|
|
HC VASOACTIVE INTESTINAL PEPTIDE/VIP
|
Facility
|
OP
|
$85.96
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
30100456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: Aetna Medicare |
$22.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.86
|
| Rate for Payer: BCBS Complete |
$15.91
|
| Rate for Payer: BCBS MAPPO |
$21.49
|
| Rate for Payer: BCBS Trust/PPO |
$70.67
|
| Rate for Payer: BCN Commercial |
$70.67
|
| Rate for Payer: BCN Medicare Advantage |
$21.49
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.49
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Mclaren Medicaid |
$15.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.56
|
| Rate for Payer: Meridian Medicaid |
$15.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: PACE Senior Care Partners |
$20.42
|
| Rate for Payer: PACE SWMI |
$21.49
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: PHP Medicare Advantage |
$21.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.79
|
| Rate for Payer: Priority Health Medicare |
$21.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.83
|
| Rate for Payer: Railroad Medicare Medicare |
$21.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.64
|
| Rate for Payer: UHC Core |
$71.78
|
| Rate for Payer: UHC Exchange |
$21.49
|
| Rate for Payer: UHC Medicaid |
$15.15
|
| Rate for Payer: UHC Medicare Advantage |
$21.49
|
| Rate for Payer: UHCCP Medicaid |
$15.15
|
| Rate for Payer: VA VA |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC VASOACTIVE INTESTINAL PEPTIDE/VIP
|
Facility
|
IP
|
$85.96
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
30100456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.83 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.64
|
| Rate for Payer: UHC Core |
$71.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
OP
|
$76.41
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$19.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.88
|
| Rate for Payer: BCBS Complete |
$14.14
|
| Rate for Payer: BCBS MAPPO |
$19.10
|
| Rate for Payer: BCBS Trust/PPO |
$62.82
|
| Rate for Payer: BCN Commercial |
$62.82
|
| Rate for Payer: BCN Medicare Advantage |
$19.10
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.10
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.31
|
| Rate for Payer: Mclaren Medicaid |
$13.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.06
|
| Rate for Payer: Meridian Medicaid |
$14.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Nomi Health Commercial |
$62.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PACE Senior Care Partners |
$18.15
|
| Rate for Payer: PACE SWMI |
$19.10
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: PHP Medicare Advantage |
$19.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.48
|
| Rate for Payer: Priority Health Medicare |
$19.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.24
|
| Rate for Payer: UHC Core |
$63.80
|
| Rate for Payer: UHC Exchange |
$19.10
|
| Rate for Payer: UHC Medicaid |
$13.47
|
| Rate for Payer: UHC Medicare Advantage |
$19.10
|
| Rate for Payer: UHCCP Medicaid |
$13.47
|
| Rate for Payer: VA VA |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.31
|
|
|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
IP
|
$76.41
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$53.18 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: BCBS Trust/PPO |
$63.11
|
| Rate for Payer: BCN Commercial |
$63.11
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Nomi Health Commercial |
$62.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.24
|
| Rate for Payer: UHC Core |
$63.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.31
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.11 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$29.80
|
| Rate for Payer: BCN Commercial |
$29.80
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
OP
|
$36.08
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: Aetna Medicare |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.28
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS MAPPO |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$29.66
|
| Rate for Payer: BCN Commercial |
$29.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.02
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Mclaren Medicaid |
$6.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.47
|
| Rate for Payer: Meridian Medicaid |
$6.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PACE Senior Care Partners |
$8.57
|
| Rate for Payer: PACE SWMI |
$9.02
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$9.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: UHC Exchange |
$9.02
|
| Rate for Payer: UHC Medicaid |
$6.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.02
|
| Rate for Payer: UHCCP Medicaid |
$6.36
|
| Rate for Payer: VA VA |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
