|
HC ANTI FACTOR XA
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.14 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health SBD |
$50.14
|
|
|
HC ANTI FACTOR XA
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$13.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.96
|
| Rate for Payer: BCN Commercial |
$13.96
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$6.85
|
| Rate for Payer: Mclaren Medicare |
$13.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$13.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$19.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.09
|
| Rate for Payer: Priority Health Medicare |
$13.09
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$10.47
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.64
|
| Rate for Payer: UHC Core |
$19.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.09
|
| Rate for Payer: UHC Exchange |
$19.64
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$13.09
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.14 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.47
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Advantage |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: Priority Health SBD |
$73.14
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.79
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: BCBS MAPPO |
$3.83
|
| Rate for Payer: BCBS Trust/PPO |
$4.08
|
| Rate for Payer: BCN Commercial |
$4.08
|
| Rate for Payer: BCN Medicare Advantage |
$3.83
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Advantage |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.83
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Mclaren Medicaid |
$2.00
|
| Rate for Payer: Mclaren Medicare |
$3.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: Meridian Medicaid |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$11.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Medicare |
$3.64
|
| Rate for Payer: PACE SWMI |
$3.83
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$3.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$3.83
|
| Rate for Payer: Priority Health SBD |
$73.14
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.75
|
| Rate for Payer: UHC Core |
$5.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.83
|
| Rate for Payer: UHC Exchange |
$5.75
|
| Rate for Payer: UHC Medicaid |
$2.00
|
| Rate for Payer: UHCCP Medicaid |
$2.00
|
| Rate for Payer: VA VA |
$3.83
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.94
|
| Rate for Payer: BCBS Complete |
$3.49
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$6.77
|
| Rate for Payer: BCN Commercial |
$6.77
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Advantage |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Mclaren Medicaid |
$3.32
|
| Rate for Payer: Mclaren Medicare |
$6.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$19.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Medicare |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$6.35
|
| Rate for Payer: Priority Health SBD |
$73.14
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.53
|
| Rate for Payer: UHC Core |
$9.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.35
|
| Rate for Payer: UHC Exchange |
$9.53
|
| Rate for Payer: UHC Medicaid |
$3.32
|
| Rate for Payer: UHCCP Medicaid |
$3.32
|
| Rate for Payer: VA VA |
$6.35
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.14 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.47
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Advantage |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: Priority Health SBD |
$73.14
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.94
|
| Rate for Payer: BCBS Complete |
$3.49
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$6.77
|
| Rate for Payer: BCN Commercial |
$6.77
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Advantage |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Mclaren Medicaid |
$3.32
|
| Rate for Payer: Mclaren Medicare |
$6.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$19.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Medicare |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$6.35
|
| Rate for Payer: Priority Health SBD |
$73.14
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.53
|
| Rate for Payer: UHC Core |
$9.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.35
|
| Rate for Payer: UHC Exchange |
$9.53
|
| Rate for Payer: UHC Medicaid |
$3.32
|
| Rate for Payer: UHCCP Medicaid |
$3.32
|
| Rate for Payer: VA VA |
$6.35
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.14 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.47
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Advantage |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: Priority Health SBD |
$73.14
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$58.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna Commercial |
$49.61
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Advantage |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$49.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$36.77
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$58.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.77 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna Commercial |
$49.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.93
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Advantage |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PHP Commercial |
$49.61
|
| Rate for Payer: Priority Health SBD |
$36.77
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Advantage |
$26.74
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$24.07
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.83
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Advantage |
$26.74
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health SBD |
$24.07
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$125.89
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna Commercial |
$107.01
|
| Rate for Payer: Aetna Medicare |
$40.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.27
|
| Rate for Payer: BCBS Complete |
$21.21
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$41.18
|
| Rate for Payer: BCN Commercial |
$41.18
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cofinity Advantage |
$88.12
|
| Rate for Payer: Cofinity Commercial |
$108.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$113.30
|
| Rate for Payer: Mclaren Medicaid |
$20.20
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$40.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.01
|
| Rate for Payer: Nomi Health Commercial |
$57.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.42
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$107.01
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.62
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health SBD |
$79.31
|
| Rate for Payer: Priority Health Tiered Network |
$30.90
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.93
|
| Rate for Payer: UHC Core |
$57.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.62
|
| Rate for Payer: UHC Exchange |
$57.93
|
| Rate for Payer: UHC Medicaid |
$20.20
|
| Rate for Payer: UHCCP Medicaid |
$20.20
|
| Rate for Payer: VA VA |
$38.62
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$125.89
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.31 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna Commercial |
$107.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.83
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cofinity Advantage |
$88.12
|
| Rate for Payer: Cofinity Commercial |
$108.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.71
|
| Rate for Payer: Healthscope Commercial |
$113.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.42
|
| Rate for Payer: PHP Commercial |
$107.01
|
| Rate for Payer: Priority Health SBD |
$79.31
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$73.54
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: Aetna Medicare |
$14.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$14.66
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Advantage |
$51.48
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$14.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$20.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.74
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health SBD |
$46.33
|
| Rate for Payer: Priority Health Tiered Network |
$10.99
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.61
|
| Rate for Payer: UHC Core |
$20.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.74
|
| Rate for Payer: UHC Exchange |
$20.61
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$13.74
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$73.54
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.33 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.80
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Advantage |
$51.48
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: Priority Health SBD |
$46.33
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$73.54
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$12.89
|
| Rate for Payer: BCN Commercial |
$12.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Advantage |
$51.48
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$12.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$18.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.09
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health SBD |
$46.33
|
| Rate for Payer: Priority Health Tiered Network |
$9.67
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$18.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$73.54
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.33 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.80
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Advantage |
$51.48
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: Priority Health SBD |
$46.33
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$12.89
|
| Rate for Payer: BCN Commercial |
$12.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$12.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$18.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.09
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$9.67
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$18.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.95
|
| Rate for Payer: BCBS Complete |
$6.13
|
| Rate for Payer: BCBS MAPPO |
$11.16
|
| Rate for Payer: BCBS Trust/PPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$11.16
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$5.84
|
| Rate for Payer: Mclaren Medicare |
$11.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.72
|
| Rate for Payer: Meridian Medicaid |
$11.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$16.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$10.60
|
| Rate for Payer: PACE SWMI |
$11.16
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$11.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.16
|
| Rate for Payer: Priority Health Medicare |
$11.16
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$8.93
|
| Rate for Payer: Railroad Medicare Medicare |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.74
|
| Rate for Payer: UHC Core |
$16.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.16
|
| Rate for Payer: UHC Exchange |
$16.74
|
| Rate for Payer: UHC Medicaid |
$5.84
|
| Rate for Payer: UHCCP Medicaid |
$5.84
|
| Rate for Payer: VA VA |
$11.16
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$12.85
|
| Rate for Payer: BCN Commercial |
$12.85
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$6.30
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$7.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.12
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.30
|
| Rate for Payer: BCBS Trust/PPO |
$7.79
|
| Rate for Payer: BCN Commercial |
$7.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.30
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Mclaren Medicare |
$7.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.67
|
| Rate for Payer: Meridian Medicaid |
$7.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$10.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Medicare |
$6.93
|
| Rate for Payer: PACE SWMI |
$7.30
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$7.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.30
|
| Rate for Payer: Priority Health Medicare |
$7.30
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Priority Health Tiered Network |
$5.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.95
|
| Rate for Payer: UHC Core |
$10.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.30
|
| Rate for Payer: UHC Exchange |
$10.95
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: VA VA |
$7.30
|
|
