|
HC CX ID BY PCR AMPLIFIED, C PARA
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600250
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, C TROP
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600251
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, C TROP
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600251
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, E CLOACAE
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600241
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, E CLOACAE
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600241
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, E COLI
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600242
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, E COLI
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600242
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, ENTERO
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600230
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, ENTERO
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600230
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, H FLU
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600237
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, H FLU
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600237
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, K OXY
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600243
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, K OXY
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600243
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, KPC
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600254
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, KPC
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600254
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, K PNEUMO
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600244
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, K PNEUMO
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600244
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, LISTERIA
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600231
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, LISTERIA
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600231
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, MECA
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600252
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, MECA
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600252
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, N MEN
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600238
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, N MEN
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600238
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
|
HC CX ID BY PCR AMPLIFIED, PROTEUS
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600245
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| 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 |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| 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 |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| 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 |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$35.50
|
| 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 CX ID BY PCR AMPLIFIED, PROTEUS
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600245
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.63
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health SBD |
$35.50
|
|
