|
HC CHEMO INFUSION FIRST HR
|
Facility
|
OP
|
$885.43
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$127.05 |
| Max. Negotiated Rate |
$992.77 |
| Rate for Payer: Aetna Commercial |
$752.62
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS Trust/PPO |
$532.90
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cofinity Commercial |
$761.47
|
| Rate for Payer: Cofinity Commercial |
$619.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Healthscope Commercial |
$796.89
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$752.62
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PHP Commercial |
$752.62
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health SBD |
$557.82
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Exchange |
$127.05
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: VA VA |
$301.34
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$802.32
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$125.08 |
| Max. Negotiated Rate |
$992.77 |
| Rate for Payer: Aetna Commercial |
$681.97
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS Trust/PPO |
$523.33
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cofinity Commercial |
$690.00
|
| Rate for Payer: Cofinity Commercial |
$561.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Healthscope Commercial |
$722.09
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.97
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PHP Commercial |
$681.97
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health SBD |
$505.46
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Exchange |
$125.08
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: VA VA |
$301.34
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$802.32
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$505.46 |
| Max. Negotiated Rate |
$722.09 |
| Rate for Payer: Aetna Commercial |
$681.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.51
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cofinity Commercial |
$561.62
|
| Rate for Payer: Cofinity Commercial |
$690.00
|
| Rate for Payer: Healthscope Commercial |
$722.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.97
|
| Rate for Payer: PHP Commercial |
$681.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.62
|
| Rate for Payer: Priority Health SBD |
$505.46
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$400.22
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$252.14 |
| Max. Negotiated Rate |
$360.20 |
| Rate for Payer: Aetna Commercial |
$340.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.14
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cofinity Commercial |
$280.15
|
| Rate for Payer: Cofinity Commercial |
$344.19
|
| Rate for Payer: Healthscope Commercial |
$360.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.19
|
| Rate for Payer: PHP Commercial |
$340.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health SBD |
$252.14
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$400.22
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$360.20 |
| Rate for Payer: Aetna Commercial |
$340.19
|
| Rate for Payer: Aetna Medicare |
$65.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.35
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$62.68
|
| Rate for Payer: BCBS Trust/PPO |
$262.34
|
| Rate for Payer: BCN Medicare Advantage |
$62.68
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cofinity Commercial |
$280.15
|
| Rate for Payer: Cofinity Commercial |
$344.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.68
|
| Rate for Payer: Healthscope Commercial |
$360.20
|
| Rate for Payer: Mclaren Medicaid |
$34.29
|
| Rate for Payer: Mclaren Medicare |
$62.68
|
| Rate for Payer: Meridian Medicaid |
$36.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.19
|
| Rate for Payer: PACE Medicare |
$59.55
|
| Rate for Payer: PACE SWMI |
$62.68
|
| Rate for Payer: PHP Commercial |
$340.19
|
| Rate for Payer: PHP Medicare Advantage |
$62.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.04
|
| Rate for Payer: Priority Health Medicare |
$62.68
|
| Rate for Payer: Priority Health Narrow Network |
$154.43
|
| Rate for Payer: Priority Health SBD |
$252.14
|
| Rate for Payer: Railroad Medicare Medicare |
$62.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.68
|
| Rate for Payer: UHC Exchange |
$62.54
|
| Rate for Payer: UHC Medicare Advantage |
$64.56
|
| Rate for Payer: VA VA |
$62.68
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
OP
|
$430.05
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$992.77 |
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS Trust/PPO |
$777.47
|
| Rate for Payer: BCBS Trust/PPO |
$777.47
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Cofinity Commercial |
$301.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health SBD |
$220.63
|
| Rate for Payer: Priority Health SBD |
$270.93
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Exchange |
$19.97
|
| Rate for Payer: UHC Exchange |
$19.97
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: VA VA |
$301.34
|
| Rate for Payer: VA VA |
$301.34
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$350.20
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$220.63 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.53
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Cofinity Commercial |
$301.04
|
| Rate for Payer: Cofinity Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health SBD |
$270.93
|
| Rate for Payer: Priority Health SBD |
$220.63
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
IP
|
$430.05
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$270.93 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.63
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$301.04
|
| Rate for Payer: Cofinity Commercial |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health SBD |
$270.93
|
| Rate for Payer: Priority Health SBD |
$220.63
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
OP
|
$350.20
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$131.30 |
| Max. Negotiated Rate |
$3,079.86 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna Medicare |
$313.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.68
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS Complete |
$173.09
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS MAPPO |
$301.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.86
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: BCN Medicare Advantage |
$301.34
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$301.04
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Cofinity Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.34
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicaid |
$164.83
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Mclaren Medicare |
$301.34
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Medicaid |
$173.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE Medicare |
$286.27
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PACE SWMI |
$301.34
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: PHP Medicare Advantage |
$301.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.77
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Medicare |
$301.34
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health Narrow Network |
$794.22
|
| Rate for Payer: Priority Health SBD |
$220.63
|
| Rate for Payer: Priority Health SBD |
$270.93
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: Railroad Medicare Medicare |
$301.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.34
|
| Rate for Payer: UHC Exchange |
$131.30
|
| Rate for Payer: UHC Exchange |
$131.30
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: UHC Medicare Advantage |
$310.38
|
| Rate for Payer: VA VA |
$301.34
|
| Rate for Payer: VA VA |
$301.34
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
IP
|
$1,530.00
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$963.90 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health SBD |
$963.90
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
OP
|
$1,530.00
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.00 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health SBD |
$963.90
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.30
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$29.40
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.70
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health SBD |
$26.46
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.46 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.30
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$29.40
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.70
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health SBD |
$26.46
|
|
|
HC CHILDHOOD ALLERGEN PROFILE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
|
|
HC CHILDHOOD ALLERGEN PROFILE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CHLAMYDIA AB IGG
|
Facility
|
OP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200239
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$20.10 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$9.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$12.73
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health SBD |
$11.45
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Core |
$20.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$11.82
|
| Rate for Payer: UHC Medicare Advantage |
$12.17
|
| Rate for Payer: VA VA |
$11.82
|
|
|
HC CHLAMYDIA AB IGG
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200239
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.45 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.82
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$12.73
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health SBD |
$11.45
|
|
|
HC CHLAMYDIA AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
30600149
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CHLAMYDIA AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
30600149
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$41.77 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$41.77
|
|
|
HC CHLAMYDIA ANTIBODIES
|
Facility
|
OP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200355
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$20.10 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$9.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$12.73
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health SBD |
$11.45
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Core |
$20.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$11.82
|
| Rate for Payer: UHC Medicare Advantage |
$12.17
|
| Rate for Payer: VA VA |
$11.82
|
|
|
HC CHLAMYDIA ANTIBODIES
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200355
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.45 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.82
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Cofinity Commercial |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health SBD |
$11.45
|
|
|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
IP
|
$19.50
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$16.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.68
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cofinity Commercial |
$13.65
|
| Rate for Payer: Cofinity Commercial |
$16.77
|
| Rate for Payer: Healthscope Commercial |
$17.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.58
|
| Rate for Payer: PHP Commercial |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health SBD |
$12.28
|
|
|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
OP
|
$19.50
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$21.56 |
| Rate for Payer: Aetna Commercial |
$16.58
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.85
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$9.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cofinity Commercial |
$13.65
|
| Rate for Payer: Cofinity Commercial |
$16.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.68
|
| Rate for Payer: Healthscope Commercial |
$17.55
|
| Rate for Payer: Mclaren Medicaid |
$6.94
|
| Rate for Payer: Mclaren Medicare |
$12.68
|
| Rate for Payer: Meridian Medicaid |
$7.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.58
|
| Rate for Payer: PACE Medicare |
$12.05
|
| Rate for Payer: PACE SWMI |
$12.68
|
| Rate for Payer: PHP Commercial |
$16.58
|
| Rate for Payer: PHP Medicare Advantage |
$12.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health SBD |
$12.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC Core |
$21.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.68
|
| Rate for Payer: UHC Exchange |
$12.68
|
| Rate for Payer: UHC Medicare Advantage |
$13.06
|
| Rate for Payer: VA VA |
$12.68
|
|
