|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
OP
|
$994.10
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$397.64 |
| Max. Negotiated Rate |
$894.69 |
| Rate for Payer: Aetna Commercial |
$844.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.16
|
| Rate for Payer: BCBS Complete |
$397.64
|
| Rate for Payer: Cash Price |
$795.28
|
| Rate for Payer: Cash Price |
$795.28
|
| Rate for Payer: Cofinity Commercial |
$695.87
|
| Rate for Payer: Cofinity Commercial |
$854.93
|
| Rate for Payer: Healthscope Commercial |
$894.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$844.98
|
| Rate for Payer: PHP Commercial |
$844.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.87
|
| Rate for Payer: Priority Health SBD |
$626.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.30
|
| Rate for Payer: UHC Exchange |
$662.09
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
IP
|
$1,261.30
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$794.62 |
| Max. Negotiated Rate |
$1,135.17 |
| Rate for Payer: Aetna Commercial |
$1,072.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.84
|
| Rate for Payer: Cash Price |
$1,009.04
|
| Rate for Payer: Cofinity Commercial |
$1,084.72
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Healthscope Commercial |
$1,135.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,072.10
|
| Rate for Payer: PHP Commercial |
$1,072.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.91
|
| Rate for Payer: Priority Health SBD |
$794.62
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
OP
|
$1,261.30
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.43 |
| Max. Negotiated Rate |
$1,135.17 |
| Rate for Payer: Aetna Commercial |
$1,072.10
|
| Rate for Payer: Aetna Medicare |
$170.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.36
|
| Rate for Payer: BCBS Complete |
$93.91
|
| Rate for Payer: BCBS MAPPO |
$163.49
|
| Rate for Payer: BCBS Trust/PPO |
$616.13
|
| Rate for Payer: BCN Medicare Advantage |
$163.49
|
| Rate for Payer: Cash Price |
$1,009.04
|
| Rate for Payer: Cash Price |
$1,009.04
|
| Rate for Payer: Cofinity Commercial |
$1,084.72
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.49
|
| Rate for Payer: Healthscope Commercial |
$1,135.17
|
| Rate for Payer: Mclaren Medicaid |
$89.43
|
| Rate for Payer: Mclaren Medicare |
$163.49
|
| Rate for Payer: Meridian Medicaid |
$93.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,072.10
|
| Rate for Payer: PACE Medicare |
$155.32
|
| Rate for Payer: PACE SWMI |
$163.49
|
| Rate for Payer: PHP Commercial |
$1,072.10
|
| Rate for Payer: PHP Medicare Advantage |
$163.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.91
|
| Rate for Payer: Priority Health Medicare |
$163.49
|
| Rate for Payer: Priority Health SBD |
$794.62
|
| Rate for Payer: Railroad Medicare Medicare |
$163.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.49
|
| Rate for Payer: UHC Exchange |
$470.21
|
| Rate for Payer: UHC Medicare Advantage |
$168.39
|
| Rate for Payer: VA VA |
$163.49
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
IP
|
$1,261.30
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$794.62 |
| Max. Negotiated Rate |
$1,135.17 |
| Rate for Payer: Aetna Commercial |
$1,072.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.84
|
| Rate for Payer: Cash Price |
$1,009.04
|
| Rate for Payer: Cofinity Commercial |
$1,084.72
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Healthscope Commercial |
$1,135.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,072.10
|
| Rate for Payer: PHP Commercial |
$1,072.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.91
|
| Rate for Payer: Priority Health SBD |
$794.62
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
OP
|
$1,261.30
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$1,135.17 |
| Rate for Payer: Aetna Commercial |
$1,072.10
|
| Rate for Payer: Aetna Medicare |
$101.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.28
|
| Rate for Payer: BCBS Complete |
$56.19
|
| Rate for Payer: BCBS MAPPO |
$97.82
|
| Rate for Payer: BCBS Trust/PPO |
$532.85
|
| Rate for Payer: BCN Medicare Advantage |
$97.82
|
| Rate for Payer: Cash Price |
$1,009.04
|
| Rate for Payer: Cash Price |
$1,009.04
|
| Rate for Payer: Cofinity Commercial |
$1,084.72
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.82
|
| Rate for Payer: Healthscope Commercial |
$1,135.17
|
| Rate for Payer: Mclaren Medicaid |
$53.51
|
| Rate for Payer: Mclaren Medicare |
$97.82
|
| Rate for Payer: Meridian Medicaid |
$56.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,072.10
|
| Rate for Payer: PACE Medicare |
$92.93
|
| Rate for Payer: PACE SWMI |
$97.82
|
| Rate for Payer: PHP Commercial |
$1,072.10
|
| Rate for Payer: PHP Medicare Advantage |
$97.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.91
|
| Rate for Payer: Priority Health Medicare |
$97.82
|
| Rate for Payer: Priority Health SBD |
$794.62
|
| Rate for Payer: Railroad Medicare Medicare |
$97.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.82
|
| Rate for Payer: UHC Exchange |
$417.82
|
| Rate for Payer: UHC Medicare Advantage |
$100.75
|
| Rate for Payer: VA VA |
$97.82
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
IP
|
$2,593.51
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,633.91 |
| Max. Negotiated Rate |
$2,334.16 |
| Rate for Payer: Aetna Commercial |
$2,204.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.78
|
| Rate for Payer: Cash Price |
$2,074.81
|
| Rate for Payer: Cofinity Commercial |
$1,815.46
|
| Rate for Payer: Cofinity Commercial |
$2,230.42
|
| Rate for Payer: Healthscope Commercial |
$2,334.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,204.48
|
| Rate for Payer: PHP Commercial |
$2,204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,815.46
|
| Rate for Payer: Priority Health SBD |
$1,633.91
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
OP
|
$2,593.51
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$335.63 |
| Max. Negotiated Rate |
$4,155.00 |
| Rate for Payer: Aetna Commercial |
$2,204.48
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$2,074.81
|
| Rate for Payer: Cash Price |
$2,074.81
|
| Rate for Payer: Cofinity Commercial |
$2,230.42
|
| Rate for Payer: Cofinity Commercial |
$1,815.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$2,334.16
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,204.48
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$2,204.48
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,815.46
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health SBD |
$1,633.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.19
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$335.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| 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 |
$4.64
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$6.33
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Mclaren Medicaid |
$4.42
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Medicaid |
$4.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.61
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.92
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.70
|
| Rate for Payer: UHC Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.08
|
| Rate for Payer: UHC Exchange |
$8.08
|
| Rate for Payer: UHC Medicare Advantage |
$8.32
|
| Rate for Payer: VA VA |
$8.08
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.61
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.92
|
| Rate for Payer: Priority Health SBD |
$32.33
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
OP
|
$40.84
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$36.76 |
| Rate for Payer: Aetna Commercial |
$34.71
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: BCBS Complete |
$5.42
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$7.39
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$32.67
|
| Rate for Payer: Cash Price |
$32.67
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$28.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$36.76
|
| Rate for Payer: Mclaren Medicaid |
$5.16
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Medicaid |
$5.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.71
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$34.71
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.59
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health SBD |
$25.73
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.33
|
| Rate for Payer: UHC Core |
$16.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$9.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.72
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
IP
|
$40.84
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.73 |
| Max. Negotiated Rate |
$36.76 |
| Rate for Payer: Aetna Commercial |
$34.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.55
|
| Rate for Payer: Cash Price |
$32.67
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$28.59
|
| Rate for Payer: Healthscope Commercial |
$36.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.71
|
| Rate for Payer: PHP Commercial |
$34.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.59
|
| Rate for Payer: Priority Health SBD |
$25.73
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
OP
|
$15.34
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$16.03 |
| Rate for Payer: Aetna Commercial |
$13.04
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: BCBS Complete |
$5.42
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$7.39
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cofinity Commercial |
$13.19
|
| Rate for Payer: Cofinity Commercial |
$10.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Mclaren Medicaid |
$5.16
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Medicaid |
$5.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.04
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$13.04
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health SBD |
$9.66
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.33
|
| Rate for Payer: UHC Core |
$16.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$9.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.72
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
IP
|
$15.34
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.66 |
| Max. Negotiated Rate |
$13.81 |
| Rate for Payer: Aetna Commercial |
$13.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.97
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cofinity Commercial |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.04
|
| Rate for Payer: PHP Commercial |
$13.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health SBD |
$9.66
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.35
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$55.30
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health SBD |
$49.77
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$8.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.51
|
| Rate for Payer: BCBS Complete |
$4.83
|
| Rate for Payer: BCBS MAPPO |
$8.41
|
| Rate for Payer: BCBS Trust/PPO |
$6.59
|
| Rate for Payer: BCN Medicare Advantage |
$8.41
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Cofinity Commercial |
$55.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.41
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$4.60
|
| Rate for Payer: Mclaren Medicare |
$8.41
|
| Rate for Payer: Meridian Medicaid |
$4.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$7.99
|
| Rate for Payer: PACE SWMI |
$8.41
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$8.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health SBD |
$49.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.09
|
| Rate for Payer: UHC Core |
$14.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.41
|
| Rate for Payer: UHC Exchange |
$8.41
|
| Rate for Payer: UHC Medicare Advantage |
$8.66
|
| Rate for Payer: VA VA |
$8.41
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$8.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.64
|
| Rate for Payer: BCBS Complete |
$4.43
|
| Rate for Payer: BCBS MAPPO |
$7.71
|
| Rate for Payer: BCBS Trust/PPO |
$6.03
|
| Rate for Payer: BCN Medicare Advantage |
$7.71
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Cofinity Commercial |
$55.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$4.22
|
| Rate for Payer: Mclaren Medicare |
$7.71
|
| Rate for Payer: Meridian Medicaid |
$4.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$7.32
|
| Rate for Payer: PACE SWMI |
$7.71
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health SBD |
$49.77
|
| Rate for Payer: Railroad Medicare Medicare |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.25
|
| Rate for Payer: UHC Core |
$13.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.71
|
| Rate for Payer: UHC Exchange |
$7.71
|
| Rate for Payer: UHC Medicare Advantage |
$7.94
|
| Rate for Payer: VA VA |
$7.71
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.35
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$55.30
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health SBD |
$49.77
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$385.56 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health SBD |
$385.56
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$119.28 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$226.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.58
|
| Rate for Payer: BCBS Complete |
$125.25
|
| Rate for Payer: BCBS MAPPO |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$170.76
|
| Rate for Payer: BCN Medicare Advantage |
$218.06
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.06
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Mclaren Medicaid |
$119.28
|
| Rate for Payer: Mclaren Medicare |
$218.06
|
| Rate for Payer: Meridian Medicaid |
$125.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PACE Medicare |
$207.16
|
| Rate for Payer: PACE SWMI |
$218.06
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$218.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health Medicare |
$218.06
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$218.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.67
|
| Rate for Payer: UHC Core |
$261.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.06
|
| Rate for Payer: UHC Exchange |
$218.06
|
| Rate for Payer: UHC Medicare Advantage |
$224.60
|
| Rate for Payer: VA VA |
$218.06
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.92 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$4.95
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$6.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$4.72
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Medicaid |
$4.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC Core |
$14.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Exchange |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC CULTURE SCREENING
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$5.19
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$3.63
|
| Rate for Payer: Mclaren Medicare |
$6.63
|
| Rate for Payer: Meridian Medicaid |
$3.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$11.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.83
|
| Rate for Payer: VA VA |
$6.63
|
|
|
HC CULTURE SCREENING
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
IP
|
$12.75
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$10.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.29
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Cofinity Commercial |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.84
|
| Rate for Payer: PHP Commercial |
$10.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.92
|
| Rate for Payer: Priority Health SBD |
$8.03
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
OP
|
$12.75
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$10.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.29
|
| Rate for Payer: BCBS Complete |
$5.10
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Cofinity Commercial |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.84
|
| Rate for Payer: PHP Commercial |
$10.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.92
|
| Rate for Payer: Priority Health SBD |
$8.03
|
|
