|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
IP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.86
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Advantage |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: Priority Health SBD |
$11.49
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
OP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: BCBS Complete |
$5.59
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$10.86
|
| Rate for Payer: BCN Commercial |
$10.86
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Advantage |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Mclaren Medicaid |
$5.32
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: Meridian Medicaid |
$10.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.18
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health SBD |
$11.49
|
| Rate for Payer: Priority Health Tiered Network |
$8.14
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC Core |
$15.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.18
|
| Rate for Payer: UHC Exchange |
$15.27
|
| Rate for Payer: UHC Medicaid |
$5.32
|
| Rate for Payer: UHCCP Medicaid |
$5.32
|
| Rate for Payer: VA VA |
$10.18
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
OP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: BCBS Complete |
$5.59
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$10.86
|
| Rate for Payer: BCN Commercial |
$10.86
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Advantage |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Mclaren Medicaid |
$5.32
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: Meridian Medicaid |
$10.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.18
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health SBD |
$11.49
|
| Rate for Payer: Priority Health Tiered Network |
$8.14
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC Core |
$15.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.18
|
| Rate for Payer: UHC Exchange |
$15.27
|
| Rate for Payer: UHC Medicaid |
$5.32
|
| Rate for Payer: UHCCP Medicaid |
$5.32
|
| Rate for Payer: VA VA |
$10.18
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
IP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.86
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Advantage |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: Priority Health SBD |
$11.49
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
IP
|
$32.48
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Advantage |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: Priority Health SBD |
$20.46
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
OP
|
$32.48
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: Aetna Medicare |
$8.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.57
|
| Rate for Payer: BCBS Complete |
$4.65
|
| Rate for Payer: BCBS MAPPO |
$8.46
|
| Rate for Payer: BCBS Trust/PPO |
$12.34
|
| Rate for Payer: BCN Commercial |
$12.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.46
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Advantage |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.46
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Mclaren Medicaid |
$4.42
|
| Rate for Payer: Mclaren Medicare |
$8.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.88
|
| Rate for Payer: Meridian Medicaid |
$8.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Nomi Health Commercial |
$12.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PACE Medicare |
$8.04
|
| Rate for Payer: PACE SWMI |
$8.46
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.46
|
| Rate for Payer: Priority Health Medicare |
$8.46
|
| Rate for Payer: Priority Health SBD |
$20.46
|
| Rate for Payer: Priority Health Tiered Network |
$6.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.69
|
| Rate for Payer: UHC Core |
$12.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.46
|
| Rate for Payer: UHC Exchange |
$12.69
|
| Rate for Payer: UHC Medicaid |
$4.42
|
| Rate for Payer: UHCCP Medicaid |
$4.42
|
| Rate for Payer: VA VA |
$8.46
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
OP
|
$96.68
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$87.01 |
| Rate for Payer: Aetna Commercial |
$82.18
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$10.89
|
| Rate for Payer: BCN Commercial |
$10.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$77.34
|
| Rate for Payer: Cash Price |
$77.34
|
| Rate for Payer: Cofinity Advantage |
$67.68
|
| Rate for Payer: Cofinity Commercial |
$83.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$87.01
|
| Rate for Payer: Mclaren Medicaid |
$7.18
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.18
|
| Rate for Payer: Nomi Health Commercial |
$20.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.51
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$82.18
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.73
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health SBD |
$60.91
|
| Rate for Payer: Priority Health Tiered Network |
$10.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.60
|
| Rate for Payer: UHC Core |
$20.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.73
|
| Rate for Payer: UHC Exchange |
$20.60
|
| Rate for Payer: UHC Medicaid |
$7.18
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: VA VA |
$13.73
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
IP
|
$96.68
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$87.01 |
| Rate for Payer: Aetna Commercial |
$82.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.84
|
| Rate for Payer: Cash Price |
$77.34
|
| Rate for Payer: Cofinity Advantage |
$67.68
|
| Rate for Payer: Cofinity Commercial |
$83.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.34
|
| Rate for Payer: Healthscope Commercial |
$87.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.51
|
| Rate for Payer: PHP Commercial |
$82.18
|
| Rate for Payer: Priority Health SBD |
$60.91
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
IP
|
$440.41
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$277.46 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.27
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Advantage |
$308.29
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: Priority Health SBD |
$277.46
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
OP
|
$440.41
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$70.05 |
| Max. Negotiated Rate |
$433.11 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna Medicare |
$139.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.41
|
| Rate for Payer: BCBS Complete |
$73.55
|
| Rate for Payer: BCBS MAPPO |
$133.93
|
| Rate for Payer: BCBS Trust/PPO |
$77.99
|
| Rate for Payer: BCN Commercial |
$77.99
|
| Rate for Payer: BCN Medicare Advantage |
$133.93
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Advantage |
$308.29
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.93
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Mclaren Medicaid |
$70.05
|
| Rate for Payer: Mclaren Medicare |
$133.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.63
|
| Rate for Payer: Meridian Medicaid |
$140.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Nomi Health Commercial |
$401.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PACE Medicare |
$127.23
|
| Rate for Payer: PACE SWMI |
$133.93
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: PHP Medicare Advantage |
$133.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$433.11
|
| Rate for Payer: Priority Health Medicare |
$133.93
|
| Rate for Payer: Priority Health SBD |
$277.46
|
| Rate for Payer: Priority Health Tiered Network |
$346.49
|
| Rate for Payer: Railroad Medicare Medicare |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.27
|
| Rate for Payer: UHC Core |
$229.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.93
|
| Rate for Payer: UHC Exchange |
$173.08
|
| Rate for Payer: UHC Medicaid |
$70.05
|
| Rate for Payer: UHCCP Medicaid |
$70.05
|
| Rate for Payer: VA VA |
$133.93
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
IP
|
$228.69
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$144.07 |
| Max. Negotiated Rate |
$205.82 |
| Rate for Payer: Aetna Commercial |
$194.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.65
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cofinity Advantage |
$160.08
|
| Rate for Payer: Cofinity Commercial |
$196.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.95
|
| Rate for Payer: Healthscope Commercial |
$205.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.52
|
| Rate for Payer: PHP Commercial |
$194.39
|
| Rate for Payer: Priority Health SBD |
$144.07
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
OP
|
$228.69
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$37.63 |
| Max. Negotiated Rate |
$232.67 |
| Rate for Payer: Aetna Commercial |
$194.39
|
| Rate for Payer: Aetna Medicare |
$74.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.94
|
| Rate for Payer: BCBS Complete |
$39.51
|
| Rate for Payer: BCBS MAPPO |
$71.95
|
| Rate for Payer: BCBS Trust/PPO |
$197.61
|
| Rate for Payer: BCN Commercial |
$197.61
|
| Rate for Payer: BCN Medicare Advantage |
$71.95
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cofinity Advantage |
$160.08
|
| Rate for Payer: Cofinity Commercial |
$196.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.95
|
| Rate for Payer: Healthscope Commercial |
$205.82
|
| Rate for Payer: Mclaren Medicaid |
$37.63
|
| Rate for Payer: Mclaren Medicare |
$71.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.55
|
| Rate for Payer: Meridian Medicaid |
$75.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.39
|
| Rate for Payer: Nomi Health Commercial |
$215.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.52
|
| Rate for Payer: PACE Medicare |
$68.35
|
| Rate for Payer: PACE SWMI |
$71.95
|
| Rate for Payer: PHP Commercial |
$194.39
|
| Rate for Payer: PHP Medicare Advantage |
$71.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$232.67
|
| Rate for Payer: Priority Health Medicare |
$71.95
|
| Rate for Payer: Priority Health SBD |
$144.07
|
| Rate for Payer: Priority Health Tiered Network |
$186.14
|
| Rate for Payer: Railroad Medicare Medicare |
$71.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.65
|
| Rate for Payer: UHC Core |
$119.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.95
|
| Rate for Payer: UHC Exchange |
$89.88
|
| Rate for Payer: UHC Medicaid |
$37.63
|
| Rate for Payer: UHCCP Medicaid |
$37.63
|
| Rate for Payer: VA VA |
$71.95
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.77
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Advantage |
$67.60
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: Priority Health SBD |
$60.84
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$54.58
|
| Rate for Payer: BCN Commercial |
$54.58
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Advantage |
$67.60
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Mclaren Medicaid |
$26.77
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$60.84
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Advantage |
$75.03
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: Priority Health SBD |
$67.52
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$22.85
|
| Rate for Payer: BCN Commercial |
$22.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Advantage |
$75.03
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$67.52
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.77
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Advantage |
$67.60
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: Priority Health SBD |
$60.84
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$54.58
|
| Rate for Payer: BCN Commercial |
$54.58
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Advantage |
$67.60
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Mclaren Medicaid |
$26.77
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$60.84
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC BCR / ABL FISH
|
Facility
|
IP
|
$133.71
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.91
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Advantage |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PHP Commercial |
$113.65
|
| Rate for Payer: Priority Health SBD |
$84.24
|
|
|
HC BCR / ABL FISH
|
Facility
|
OP
|
$133.71
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$22.85
|
| Rate for Payer: BCN Commercial |
$22.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Advantage |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$113.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$84.24
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Advantage |
$75.03
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: Priority Health SBD |
$67.52
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$22.85
|
| Rate for Payer: BCN Commercial |
$22.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Advantage |
$75.03
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$67.52
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$76.79 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$54.58
|
| Rate for Payer: BCN Commercial |
$54.58
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Advantage |
$55.60
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Mclaren Medicaid |
$26.77
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$50.04
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.04 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.63
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Advantage |
$55.60
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: Priority Health SBD |
$50.04
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$397.95
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.75 |
| Max. Negotiated Rate |
$491.88 |
| Rate for Payer: Aetna Commercial |
$338.26
|
| Rate for Payer: Aetna Medicare |
$170.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: BCBS Complete |
$90.05
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$174.81
|
| Rate for Payer: BCN Commercial |
$174.81
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cofinity Advantage |
$278.56
|
| Rate for Payer: Cofinity Commercial |
$342.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$358.15
|
| Rate for Payer: Mclaren Medicaid |
$85.75
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$172.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.26
|
| Rate for Payer: Nomi Health Commercial |
$491.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.46
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$338.26
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$163.96
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health SBD |
$250.71
|
| Rate for Payer: Priority Health Tiered Network |
$131.17
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.94
|
| Rate for Payer: UHC Core |
$245.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.96
|
| Rate for Payer: UHC Exchange |
$245.94
|
| Rate for Payer: UHC Medicaid |
$85.75
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: VA VA |
$163.96
|
|
