|
HC AMYLASE SERUM
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.05 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$6.91
|
| Rate for Payer: BCN Commercial |
$6.91
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$3.39
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.48
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.72
|
| Rate for Payer: UHC Core |
$9.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.48
|
| Rate for Payer: UHC Exchange |
$9.72
|
| Rate for Payer: UHC Medicaid |
$3.39
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
IP
|
$127.03
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.03 |
| Max. Negotiated Rate |
$114.33 |
| Rate for Payer: Aetna Commercial |
$107.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.57
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cofinity Advantage |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$109.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.62
|
| Rate for Payer: Healthscope Commercial |
$114.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.27
|
| Rate for Payer: PHP Commercial |
$107.98
|
| Rate for Payer: Priority Health SBD |
$80.03
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
OP
|
$127.03
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$114.33 |
| Rate for Payer: Aetna Commercial |
$107.98
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$9.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: BCN Commercial |
$10.09
|
| Rate for Payer: BCN Medicare Advantage |
$9.47
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cofinity Advantage |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$109.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.47
|
| Rate for Payer: Healthscope Commercial |
$114.33
|
| Rate for Payer: Mclaren Medicaid |
$4.95
|
| Rate for Payer: Mclaren Medicare |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.94
|
| Rate for Payer: Meridian Medicaid |
$9.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$14.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.27
|
| Rate for Payer: PACE Medicare |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.47
|
| Rate for Payer: PHP Commercial |
$107.98
|
| Rate for Payer: PHP Medicare Advantage |
$9.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.47
|
| Rate for Payer: Priority Health Medicare |
$9.47
|
| Rate for Payer: Priority Health SBD |
$80.03
|
| Rate for Payer: Priority Health Tiered Network |
$7.58
|
| Rate for Payer: Railroad Medicare Medicare |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.21
|
| Rate for Payer: UHC Core |
$14.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.47
|
| Rate for Payer: UHC Exchange |
$14.21
|
| Rate for Payer: UHC Medicaid |
$4.95
|
| Rate for Payer: UHCCP Medicaid |
$4.95
|
| Rate for Payer: VA VA |
$9.47
|
|
|
HC ANAEROBIC ID
|
Facility
|
IP
|
$53.39
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.64 |
| Max. Negotiated Rate |
$48.05 |
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.70
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Advantage |
$37.37
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Healthscope Commercial |
$48.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PHP Commercial |
$45.38
|
| Rate for Payer: Priority Health SBD |
$33.64
|
|
|
HC ANAEROBIC ID
|
Facility
|
OP
|
$53.39
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$48.05 |
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$8.61
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Advantage |
$37.37
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$48.05
|
| Rate for Payer: Mclaren Medicaid |
$4.23
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: Meridian Medicaid |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$12.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$45.38
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.08
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health SBD |
$33.64
|
| Rate for Payer: Priority Health Tiered Network |
$6.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.12
|
| Rate for Payer: UHC Core |
$12.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.08
|
| Rate for Payer: UHC Exchange |
$12.12
|
| Rate for Payer: UHC Medicaid |
$4.23
|
| Rate for Payer: UHCCP Medicaid |
$4.23
|
| Rate for Payer: VA VA |
$8.08
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
OP
|
$312.12
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.54 |
| Max. Negotiated Rate |
$306.34 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna Medicare |
$98.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.41
|
| Rate for Payer: BCBS Complete |
$52.03
|
| Rate for Payer: BCBS MAPPO |
$94.73
|
| Rate for Payer: BCBS Trust/PPO |
$72.55
|
| Rate for Payer: BCN Commercial |
$72.55
|
| Rate for Payer: BCN Medicare Advantage |
$94.73
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.73
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Mclaren Medicaid |
$49.54
|
| Rate for Payer: Mclaren Medicare |
$94.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.47
|
| Rate for Payer: Meridian Medicaid |
$99.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Nomi Health Commercial |
$284.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PACE Medicare |
$89.99
|
| Rate for Payer: PACE SWMI |
$94.73
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: PHP Medicare Advantage |
$94.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$306.34
|
| Rate for Payer: Priority Health Medicare |
$94.73
|
| Rate for Payer: Priority Health SBD |
$196.64
|
| Rate for Payer: Priority Health Tiered Network |
$245.07
|
| Rate for Payer: Railroad Medicare Medicare |
$94.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.88
|
| Rate for Payer: UHC Core |
$162.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.73
|
| Rate for Payer: UHC Exchange |
$122.66
|
| Rate for Payer: UHC Medicaid |
$49.54
|
| Rate for Payer: UHCCP Medicaid |
$49.54
|
| Rate for Payer: VA VA |
$94.73
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
IP
|
$312.12
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.64 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: Priority Health SBD |
$196.64
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
IP
|
$446.76
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$281.46 |
| Max. Negotiated Rate |
$402.08 |
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: Priority Health SBD |
$281.46
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
OP
|
$446.76
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$655.84 |
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$655.84
|
| Rate for Payer: BCN Commercial |
$655.84
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$281.46
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.39
|
| Rate for Payer: UHC Core |
$232.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$175.58
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
IP
|
$446.76
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.46 |
| Max. Negotiated Rate |
$402.08 |
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: Priority Health SBD |
$281.46
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
OP
|
$446.76
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$414.63 |
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$395.27
|
| Rate for Payer: BCN Commercial |
$395.27
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$281.46
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.39
|
| Rate for Payer: UHC Core |
$232.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$175.58
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.10 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Advantage |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health SBD |
$72.10
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$120.26 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$38.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.49
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS MAPPO |
$37.19
|
| Rate for Payer: BCBS Trust/PPO |
$51.81
|
| Rate for Payer: BCN Commercial |
$51.81
|
| Rate for Payer: BCN Medicare Advantage |
$37.19
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Advantage |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.19
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Mclaren Medicaid |
$19.45
|
| Rate for Payer: Mclaren Medicare |
$37.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.05
|
| Rate for Payer: Meridian Medicaid |
$39.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$111.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Medicare |
$35.33
|
| Rate for Payer: PACE SWMI |
$37.19
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: PHP Medicare Advantage |
$37.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.26
|
| Rate for Payer: Priority Health Medicare |
$37.19
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: Priority Health Tiered Network |
$96.21
|
| Rate for Payer: Railroad Medicare Medicare |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.39
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.19
|
| Rate for Payer: UHC Exchange |
$44.97
|
| Rate for Payer: UHC Medicaid |
$19.45
|
| Rate for Payer: UHCCP Medicaid |
$19.45
|
| Rate for Payer: VA VA |
$37.19
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
IP
|
$17.23
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna Commercial |
$14.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: Cash Price |
$13.78
|
| Rate for Payer: Cofinity Advantage |
$12.06
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.65
|
| Rate for Payer: Priority Health SBD |
$10.85
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
OP
|
$17.23
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna Commercial |
$14.65
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: Cash Price |
$13.78
|
| Rate for Payer: Cofinity Advantage |
$12.06
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.65
|
| Rate for Payer: Priority Health SBD |
$10.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$8.98
|
| Rate for Payer: UHC Exchange |
$6.77
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.08
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$31.22
|
| Rate for Payer: BCN Commercial |
$31.22
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Mclaren Medicaid |
$15.31
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$43.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.28
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$34.76
|
| Rate for Payer: Priority Health Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.92
|
| Rate for Payer: UHC Core |
$43.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.28
|
| Rate for Payer: UHC Exchange |
$43.92
|
| Rate for Payer: UHC Medicaid |
$15.31
|
| Rate for Payer: UHCCP Medicaid |
$15.31
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health SBD |
$34.76
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.08
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$31.22
|
| Rate for Payer: BCN Commercial |
$31.22
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Advantage |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Mclaren Medicaid |
$15.31
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: Nomi Health Commercial |
$43.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.28
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: Priority Health Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.92
|
| Rate for Payer: UHC Core |
$43.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.28
|
| Rate for Payer: UHC Exchange |
$43.92
|
| Rate for Payer: UHC Medicaid |
$15.31
|
| Rate for Payer: UHCCP Medicaid |
$15.31
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.89 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Advantage |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: Priority Health SBD |
$64.89
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
OP
|
$444.11
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$174.54 |
| Max. Negotiated Rate |
$399.70 |
| Rate for Payer: Aetna Commercial |
$377.49
|
| Rate for Payer: Aetna Medicare |
$222.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.67
|
| Rate for Payer: BCBS Complete |
$177.64
|
| Rate for Payer: Cash Price |
$355.29
|
| Rate for Payer: Cofinity Advantage |
$310.88
|
| Rate for Payer: Cofinity Commercial |
$381.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.29
|
| Rate for Payer: Healthscope Commercial |
$399.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.08
|
| Rate for Payer: PHP Commercial |
$377.49
|
| Rate for Payer: Priority Health SBD |
$279.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.67
|
| Rate for Payer: UHC Core |
$231.38
|
| Rate for Payer: UHC Exchange |
$174.54
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
IP
|
$444.11
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$279.79 |
| Max. Negotiated Rate |
$399.70 |
| Rate for Payer: Aetna Commercial |
$377.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.67
|
| Rate for Payer: Cash Price |
$355.29
|
| Rate for Payer: Cofinity Advantage |
$310.88
|
| Rate for Payer: Cofinity Commercial |
$381.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.29
|
| Rate for Payer: Healthscope Commercial |
$399.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.08
|
| Rate for Payer: PHP Commercial |
$377.49
|
| Rate for Payer: Priority Health SBD |
$279.79
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health SBD |
$32.76
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$22.85
|
| Rate for Payer: BCN Commercial |
$22.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
IP
|
$141.14
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.92 |
| Max. Negotiated Rate |
$127.03 |
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: Cash Price |
$112.91
|
| Rate for Payer: Cofinity Advantage |
$98.80
|
| Rate for Payer: Cofinity Commercial |
$121.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.91
|
| Rate for Payer: Healthscope Commercial |
$127.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.86
|
| Rate for Payer: PHP Commercial |
$119.97
|
| Rate for Payer: Priority Health SBD |
$88.92
|
|
