|
HC SARS-COV2/FLU A&B
|
Facility
|
OP
|
$222.85
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
30600318
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$427.89 |
| Rate for Payer: Aetna American Axle |
$144.85
|
| Rate for Payer: Aetna Commercial |
$189.42
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$78.33
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$164.87
|
| Rate for Payer: BCN Commercial |
$164.87
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$178.28
|
| Rate for Payer: Cash Price |
$178.28
|
| Rate for Payer: Cofinity Advantage |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$191.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$200.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.14
|
| Rate for Payer: Mclaren Medicaid |
$142.63
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: Meridian Medicaid |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.42
|
| Rate for Payer: Nomi Health Commercial |
$427.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.14
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$189.42
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.63
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health SBD |
$140.40
|
| Rate for Payer: Priority Health Tiered Network |
$114.10
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.95
|
| Rate for Payer: UHC Core |
$213.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.63
|
| Rate for Payer: UHC Exchange |
$213.95
|
| Rate for Payer: UHC Medicaid |
$74.60
|
| Rate for Payer: UHCCP Medicaid |
$74.60
|
| Rate for Payer: UMR Bronson Commercial |
$82.45
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.14
|
|
|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$114.40 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna American Axle |
$169.00
|
| Rate for Payer: Aetna Commercial |
$221.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Advantage |
$182.00
|
| Rate for Payer: Cofinity Commercial |
$223.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.00
|
| Rate for Payer: Healthscope Commercial |
$234.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PHP Commercial |
$221.00
|
| Rate for Payer: Priority Health SBD |
$163.80
|
| Rate for Payer: UMR Bronson Commercial |
$114.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.00
|
|
|
HC SARS-COV2/FLU A&B/RSV
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600319
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$427.89 |
| Rate for Payer: Aetna American Axle |
$169.00
|
| Rate for Payer: Aetna Commercial |
$221.00
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$78.33
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$164.87
|
| Rate for Payer: BCN Commercial |
$164.87
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Advantage |
$182.00
|
| Rate for Payer: Cofinity Commercial |
$223.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$234.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.00
|
| Rate for Payer: Mclaren Medicaid |
$142.63
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: Meridian Medicaid |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Nomi Health Commercial |
$427.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$221.00
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.63
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health SBD |
$163.80
|
| Rate for Payer: Priority Health Tiered Network |
$114.10
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.95
|
| Rate for Payer: UHC Core |
$213.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.63
|
| Rate for Payer: UHC Exchange |
$213.95
|
| Rate for Payer: UHC Medicaid |
$74.60
|
| Rate for Payer: UHCCP Medicaid |
$74.60
|
| Rate for Payer: UMR Bronson Commercial |
$96.20
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.00
|
|
|
HC SARSCOV2 INF AB RSV AMP PRB
|
Facility
|
IP
|
$255.32
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600344
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$112.34 |
| Max. Negotiated Rate |
$229.79 |
| Rate for Payer: Aetna American Axle |
$165.96
|
| Rate for Payer: Aetna Commercial |
$217.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.96
|
| Rate for Payer: Cash Price |
$204.26
|
| Rate for Payer: Cofinity Advantage |
$178.72
|
| Rate for Payer: Cofinity Commercial |
$219.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.26
|
| Rate for Payer: Healthscope Commercial |
$229.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.49
|
| Rate for Payer: PHP Commercial |
$217.02
|
| Rate for Payer: Priority Health SBD |
$160.85
|
| Rate for Payer: UMR Bronson Commercial |
$112.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.49
|
|
|
HC SARSCOV2 INF AB RSV AMP PRB
|
Facility
|
OP
|
$255.32
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600344
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$427.89 |
| Rate for Payer: Aetna American Axle |
$165.96
|
| Rate for Payer: Aetna Commercial |
$217.02
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$78.33
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$164.87
|
| Rate for Payer: BCN Commercial |
$164.87
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$204.26
|
| Rate for Payer: Cash Price |
$204.26
|
| Rate for Payer: Cofinity Advantage |
$178.72
|
| Rate for Payer: Cofinity Commercial |
$219.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$229.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.49
|
| Rate for Payer: Mclaren Medicaid |
$142.63
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: Meridian Medicaid |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.02
|
| Rate for Payer: Nomi Health Commercial |
$427.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.49
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$217.02
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.63
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health SBD |
$160.85
|
| Rate for Payer: Priority Health Tiered Network |
$114.10
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.95
|
| Rate for Payer: UHC Core |
$213.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.63
|
| Rate for Payer: UHC Exchange |
$213.95
|
| Rate for Payer: UHC Medicaid |
$74.60
|
| Rate for Payer: UHCCP Medicaid |
$74.60
|
| Rate for Payer: UMR Bronson Commercial |
$94.47
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.49
|
|
|
HC SARSCOV2 INF AB RSV PCR CEPHEID
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600356
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$427.89 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$78.33
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$164.87
|
| Rate for Payer: BCN Commercial |
$164.87
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Advantage |
$174.93
|
| 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 |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.43
|
| Rate for Payer: Mclaren Medicaid |
$142.63
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: Meridian Medicaid |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$427.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.43
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.63
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: Priority Health Tiered Network |
$114.10
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.95
|
| Rate for Payer: UHC Core |
$213.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.63
|
| Rate for Payer: UHC Exchange |
$213.95
|
| Rate for Payer: UHC Medicaid |
$74.60
|
| Rate for Payer: UHCCP Medicaid |
$74.60
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
HC SARSCOV2 INF AB RSV PCR CEPHEID
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600356
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Advantage |
$174.93
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.43
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: UMR Bronson Commercial |
$109.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$223.51
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$98.34 |
| Max. Negotiated Rate |
$201.16 |
| Rate for Payer: Aetna American Axle |
$145.28
|
| Rate for Payer: Aetna Commercial |
$189.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.28
|
| Rate for Payer: Cash Price |
$178.81
|
| Rate for Payer: Cofinity Advantage |
$156.46
|
| Rate for Payer: Cofinity Commercial |
$192.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.81
|
| Rate for Payer: Healthscope Commercial |
$201.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.63
|
| Rate for Payer: PHP Commercial |
$189.98
|
| Rate for Payer: Priority Health SBD |
$140.81
|
| Rate for Payer: UMR Bronson Commercial |
$98.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.63
|
|
|
HC SARSCOV2 VAC 10MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$223.51
|
|
|
Service Code
|
CPT 91319
|
| Hospital Charge Code |
63600230
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.84 |
| Max. Negotiated Rate |
$264.67 |
| Rate for Payer: Aetna American Axle |
$145.28
|
| Rate for Payer: Aetna Commercial |
$189.98
|
| Rate for Payer: Aetna Medicare |
$111.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.28
|
| Rate for Payer: BCBS Complete |
$89.40
|
| Rate for Payer: BCBS Trust/PPO |
$264.67
|
| Rate for Payer: BCN Commercial |
$264.67
|
| Rate for Payer: Cash Price |
$178.81
|
| Rate for Payer: Cash Price |
$178.81
|
| Rate for Payer: Cofinity Advantage |
$156.46
|
| Rate for Payer: Cofinity Commercial |
$192.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.81
|
| Rate for Payer: Healthscope Commercial |
$201.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.63
|
| Rate for Payer: PHP Commercial |
$189.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.80
|
| Rate for Payer: Priority Health SBD |
$140.81
|
| Rate for Payer: Priority Health Tiered Network |
$75.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.42
|
| Rate for Payer: UHC Core |
$156.42
|
| Rate for Payer: UHC Exchange |
$156.42
|
| Rate for Payer: UMR Bronson Commercial |
$82.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.63
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$333.82
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.88 |
| Max. Negotiated Rate |
$300.44 |
| Rate for Payer: Aetna American Axle |
$216.98
|
| Rate for Payer: Aetna Commercial |
$283.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.98
|
| Rate for Payer: Cash Price |
$267.06
|
| Rate for Payer: Cofinity Advantage |
$233.67
|
| Rate for Payer: Cofinity Commercial |
$287.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.06
|
| Rate for Payer: Healthscope Commercial |
$300.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.37
|
| Rate for Payer: PHP Commercial |
$283.75
|
| Rate for Payer: Priority Health SBD |
$210.31
|
| Rate for Payer: UMR Bronson Commercial |
$146.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.37
|
|
|
HC SARSCOV2 VAC 30MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$333.82
|
|
|
Service Code
|
CPT 91320
|
| Hospital Charge Code |
63600231
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$123.51 |
| Max. Negotiated Rate |
$537.67 |
| Rate for Payer: Aetna American Axle |
$216.98
|
| Rate for Payer: Aetna Commercial |
$283.75
|
| Rate for Payer: Aetna Medicare |
$166.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.98
|
| Rate for Payer: BCBS Complete |
$133.53
|
| Rate for Payer: BCBS Trust/PPO |
$537.67
|
| Rate for Payer: BCN Commercial |
$537.67
|
| Rate for Payer: Cash Price |
$267.06
|
| Rate for Payer: Cash Price |
$267.06
|
| Rate for Payer: Cofinity Advantage |
$233.67
|
| Rate for Payer: Cofinity Commercial |
$287.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.06
|
| Rate for Payer: Healthscope Commercial |
$300.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.37
|
| Rate for Payer: PHP Commercial |
$283.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$168.37
|
| Rate for Payer: Priority Health SBD |
$210.31
|
| Rate for Payer: Priority Health Tiered Network |
$134.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.81
|
| Rate for Payer: UHC Core |
$277.81
|
| Rate for Payer: UHC Exchange |
$277.81
|
| Rate for Payer: UMR Bronson Commercial |
$123.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.37
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
OP
|
$166.92
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Aetna American Axle |
$108.50
|
| Rate for Payer: Aetna Commercial |
$141.88
|
| Rate for Payer: Aetna Medicare |
$83.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.50
|
| Rate for Payer: BCBS Complete |
$66.77
|
| Rate for Payer: BCBS Trust/PPO |
$183.00
|
| Rate for Payer: BCN Commercial |
$183.00
|
| Rate for Payer: Cash Price |
$133.54
|
| Rate for Payer: Cash Price |
$133.54
|
| Rate for Payer: Cofinity Advantage |
$116.84
|
| Rate for Payer: Cofinity Commercial |
$143.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.54
|
| Rate for Payer: Healthscope Commercial |
$150.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.19
|
| Rate for Payer: PHP Commercial |
$141.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.55
|
| Rate for Payer: Priority Health SBD |
$105.16
|
| Rate for Payer: Priority Health Tiered Network |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.03
|
| Rate for Payer: UHC Core |
$108.03
|
| Rate for Payer: UHC Exchange |
$108.03
|
| Rate for Payer: UMR Bronson Commercial |
$61.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.19
|
|
|
HC SARSCOV2 VAC 3MCG/0.3ML TRS-SUC IM
|
Facility
|
IP
|
$166.92
|
|
|
Service Code
|
CPT 91318
|
| Hospital Charge Code |
63600229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.44 |
| Max. Negotiated Rate |
$150.23 |
| Rate for Payer: Aetna American Axle |
$108.50
|
| Rate for Payer: Aetna Commercial |
$141.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.50
|
| Rate for Payer: Cash Price |
$133.54
|
| Rate for Payer: Cofinity Advantage |
$116.84
|
| Rate for Payer: Cofinity Commercial |
$143.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.54
|
| Rate for Payer: Healthscope Commercial |
$150.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.19
|
| Rate for Payer: PHP Commercial |
$141.88
|
| Rate for Payer: Priority Health SBD |
$105.16
|
| Rate for Payer: UMR Bronson Commercial |
$73.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.19
|
|
|
HC SARSCOV2 VAC 5MCG/0.5ML IM NOVAVAX
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT 91304
|
| Hospital Charge Code |
63600211
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$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: Kalamazoo County Sherrif's Dept 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: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| 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 |
$535.79 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$535.79
|
| Rate for Payer: BCN Commercial |
$535.79
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$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: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$191.92
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: Priority Health Tiered Network |
$153.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.67
|
| Rate for Payer: UHC Core |
$316.67
|
| Rate for Payer: UHC Exchange |
$316.67
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE
|
Facility
|
OP
|
$345.69
|
|
|
Service Code
|
CPT 91321
|
| Hospital Charge Code |
63600276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$117.65 |
| Max. Negotiated Rate |
$410.56 |
| Rate for Payer: Aetna American Axle |
$224.70
|
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: Aetna Medicare |
$172.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.70
|
| Rate for Payer: BCBS Complete |
$138.28
|
| Rate for Payer: BCBS Trust/PPO |
$410.56
|
| Rate for Payer: BCN Commercial |
$410.56
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Advantage |
$241.98
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$147.06
|
| Rate for Payer: Priority Health SBD |
$217.78
|
| Rate for Payer: Priority Health Tiered Network |
$117.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.65
|
| Rate for Payer: UHC Core |
$242.65
|
| Rate for Payer: UHC Exchange |
$242.65
|
| Rate for Payer: UMR Bronson Commercial |
$127.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE
|
Facility
|
IP
|
$345.69
|
|
|
Service Code
|
CPT 91321
|
| Hospital Charge Code |
63600276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$152.10 |
| Max. Negotiated Rate |
$311.12 |
| Rate for Payer: Aetna American Axle |
$224.70
|
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.70
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Advantage |
$241.98
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: Priority Health SBD |
$217.78
|
| Rate for Payer: UMR Bronson Commercial |
$152.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE
|
Facility
|
OP
|
$345.69
|
|
|
Service Code
|
CPT 91322
|
| Hospital Charge Code |
63600277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.91 |
| Max. Negotiated Rate |
$451.29 |
| Rate for Payer: Aetna American Axle |
$224.70
|
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: Aetna Medicare |
$172.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.70
|
| Rate for Payer: BCBS Complete |
$138.28
|
| Rate for Payer: BCBS Trust/PPO |
$451.29
|
| Rate for Payer: BCN Commercial |
$451.29
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Advantage |
$241.98
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.65
|
| Rate for Payer: Priority Health SBD |
$217.78
|
| Rate for Payer: Priority Health Tiered Network |
$129.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.72
|
| Rate for Payer: UHC Core |
$266.72
|
| Rate for Payer: UHC Exchange |
$266.72
|
| Rate for Payer: UMR Bronson Commercial |
$127.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE
|
Facility
|
IP
|
$345.69
|
|
|
Service Code
|
CPT 91322
|
| Hospital Charge Code |
63600277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$152.10 |
| Max. Negotiated Rate |
$311.12 |
| Rate for Payer: Aetna American Axle |
$224.70
|
| Rate for Payer: Aetna Commercial |
$293.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.70
|
| Rate for Payer: Cash Price |
$276.55
|
| Rate for Payer: Cofinity Advantage |
$241.98
|
| Rate for Payer: Cofinity Commercial |
$297.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.55
|
| Rate for Payer: Healthscope Commercial |
$311.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.27
|
| Rate for Payer: PHP Commercial |
$293.84
|
| Rate for Payer: Priority Health SBD |
$217.78
|
| Rate for Payer: UMR Bronson Commercial |
$152.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.27
|
|
|
HC SARSCOV AG
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: UMR Bronson Commercial |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC SARSCOV AG
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600336
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.48 |
| Max. Negotiated Rate |
$105.99 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$36.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.16
|
| Rate for Payer: BCBS Complete |
$19.40
|
| Rate for Payer: BCBS MAPPO |
$35.33
|
| Rate for Payer: BCBS Trust/PPO |
$54.45
|
| Rate for Payer: BCN Commercial |
$54.45
|
| Rate for Payer: BCN Medicare Advantage |
$35.33
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.33
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.33
|
| Rate for Payer: Mclaren Medicare |
$35.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.10
|
| Rate for Payer: Meridian Medicaid |
$37.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$105.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.56
|
| Rate for Payer: PACE SWMI |
$35.33
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$35.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.33
|
| Rate for Payer: Priority Health Medicare |
$35.33
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$28.26
|
| Rate for Payer: Railroad Medicare Medicare |
$35.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.00
|
| Rate for Payer: UHC Core |
$53.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.33
|
| Rate for Payer: UHC Exchange |
$53.00
|
| Rate for Payer: UHC Medicaid |
$18.48
|
| Rate for Payer: UHCCP Medicaid |
$18.48
|
| Rate for Payer: UMR Bronson Commercial |
$23.56
|
| Rate for Payer: VA VA |
$35.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
OP
|
$63.25
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.48 |
| Max. Negotiated Rate |
$105.99 |
| Rate for Payer: Aetna American Axle |
$41.11
|
| Rate for Payer: Aetna Commercial |
$53.76
|
| Rate for Payer: Aetna Medicare |
$36.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.16
|
| Rate for Payer: BCBS Complete |
$19.40
|
| Rate for Payer: BCBS MAPPO |
$35.33
|
| Rate for Payer: BCBS Trust/PPO |
$54.45
|
| Rate for Payer: BCN Commercial |
$54.45
|
| Rate for Payer: BCN Medicare Advantage |
$35.33
|
| Rate for Payer: Cash Price |
$50.60
|
| Rate for Payer: Cash Price |
$50.60
|
| Rate for Payer: Cofinity Advantage |
$44.27
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.33
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Mclaren Medicaid |
$35.33
|
| Rate for Payer: Mclaren Medicare |
$35.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.10
|
| Rate for Payer: Meridian Medicaid |
$37.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.76
|
| Rate for Payer: Nomi Health Commercial |
$105.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.44
|
| Rate for Payer: PACE Medicare |
$33.56
|
| Rate for Payer: PACE SWMI |
$35.33
|
| Rate for Payer: PHP Commercial |
$53.76
|
| Rate for Payer: PHP Medicare Advantage |
$35.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.33
|
| Rate for Payer: Priority Health Medicare |
$35.33
|
| Rate for Payer: Priority Health SBD |
$39.85
|
| Rate for Payer: Priority Health Tiered Network |
$28.26
|
| Rate for Payer: Railroad Medicare Medicare |
$35.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.00
|
| Rate for Payer: UHC Core |
$53.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.33
|
| Rate for Payer: UHC Exchange |
$53.00
|
| Rate for Payer: UHC Medicaid |
$18.48
|
| Rate for Payer: UHCCP Medicaid |
$18.48
|
| Rate for Payer: UMR Bronson Commercial |
$23.40
|
| Rate for Payer: VA VA |
$35.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC SARSCOV CORONAVIRUS AG IA
|
Facility
|
IP
|
$63.25
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
30600331
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.83 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna American Axle |
$41.11
|
| Rate for Payer: Aetna Commercial |
$53.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: Cash Price |
$50.60
|
| Rate for Payer: Cofinity Advantage |
$44.27
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.60
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.44
|
| Rate for Payer: PHP Commercial |
$53.76
|
| Rate for Payer: Priority Health SBD |
$39.85
|
| Rate for Payer: UMR Bronson Commercial |
$27.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC SARS FLU AB RSV
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$114.40 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna American Axle |
$169.00
|
| Rate for Payer: Aetna Commercial |
$221.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Advantage |
$182.00
|
| Rate for Payer: Cofinity Commercial |
$223.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.00
|
| Rate for Payer: Healthscope Commercial |
$234.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PHP Commercial |
$221.00
|
| Rate for Payer: Priority Health SBD |
$163.80
|
| Rate for Payer: UMR Bronson Commercial |
$114.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.00
|
|
|
HC SARS FLU AB RSV
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 0241U
|
| Hospital Charge Code |
30600313
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$96.20 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna American Axle |
$169.00
|
| Rate for Payer: Aetna Commercial |
$221.00
|
| Rate for Payer: Aetna Medicare |
$130.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.00
|
| Rate for Payer: BCBS Complete |
$104.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Advantage |
$182.00
|
| Rate for Payer: Cofinity Commercial |
$223.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.00
|
| Rate for Payer: Healthscope Commercial |
$234.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PHP Commercial |
$221.00
|
| Rate for Payer: Priority Health SBD |
$163.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.00
|
| Rate for Payer: UHC Core |
$130.00
|
| Rate for Payer: UHC Exchange |
$130.00
|
| Rate for Payer: UMR Bronson Commercial |
$96.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.00
|
|
