|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$358.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$225.54 |
| Max. Negotiated Rate |
$322.20 |
| Rate for Payer: Aetna Commercial |
$304.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.70
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$250.60
|
| Rate for Payer: Cofinity Commercial |
$307.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.40
|
| Rate for Payer: Healthscope Commercial |
$322.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.30
|
| Rate for Payer: PHP Commercial |
$304.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health SBD |
$225.54
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$358.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.30 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$304.30
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$54.18
|
| Rate for Payer: BCN Commercial |
$54.18
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$250.60
|
| Rate for Payer: Cofinity Commercial |
$307.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$322.20
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.30
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$304.30
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$225.54
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.30
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$71.10
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
OP
|
$1,567.19
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.05 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$68.13
|
| Rate for Payer: BCN Commercial |
$68.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Cofinity Commercial |
$1,097.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,097.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$987.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.05
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$650.40
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
IP
|
$1,567.19
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$987.33 |
| Max. Negotiated Rate |
$1,410.47 |
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.67
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,097.03
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,097.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health SBD |
$987.33
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
OP
|
$2,074.35
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.97 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Commercial |
$1,763.20
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$360.33
|
| Rate for Payer: BCN Commercial |
$360.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cofinity Commercial |
$1,783.94
|
| Rate for Payer: Cofinity Commercial |
$1,452.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,452.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,866.92
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.20
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,763.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$1,306.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.97
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$650.40
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
IP
|
$2,074.35
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,306.84 |
| Max. Negotiated Rate |
$1,866.92 |
| Rate for Payer: Aetna Commercial |
$1,763.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.33
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cofinity Commercial |
$1,452.04
|
| Rate for Payer: Cofinity Commercial |
$1,783.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,452.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.48
|
| Rate for Payer: Healthscope Commercial |
$1,866.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.20
|
| Rate for Payer: PHP Commercial |
$1,763.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.33
|
| Rate for Payer: Priority Health SBD |
$1,306.84
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
OP
|
$117.81
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$182.90 |
| Rate for Payer: Aetna Commercial |
$100.14
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$10.85
|
| Rate for Payer: BCN Commercial |
$10.85
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cofinity Commercial |
$82.47
|
| Rate for Payer: Cofinity Commercial |
$101.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$106.03
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.14
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$100.14
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$74.22
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$87.18
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$32.77
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
IP
|
$117.81
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.22 |
| Max. Negotiated Rate |
$106.03 |
| Rate for Payer: Aetna Commercial |
$100.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.58
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cofinity Commercial |
$101.32
|
| Rate for Payer: Cofinity Commercial |
$82.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.25
|
| Rate for Payer: Healthscope Commercial |
$106.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.14
|
| Rate for Payer: PHP Commercial |
$100.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.58
|
| Rate for Payer: Priority Health SBD |
$74.22
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.40
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$10.72
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.40
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$10.72
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.42 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.88
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$16.02
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health SBD |
$14.42
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$16.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.40
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$10.72
|
| Rate for Payer: Priority Health SBD |
$14.42
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.42 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.88
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$16.02
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health SBD |
$14.42
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$16.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.40
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$10.72
|
| Rate for Payer: Priority Health SBD |
$14.42
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
OP
|
$299.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$527.71 |
| Rate for Payer: Aetna Commercial |
$254.81
|
| Rate for Payer: Aetna Medicare |
$174.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$10.85
|
| Rate for Payer: BCN Commercial |
$10.85
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$239.82
|
| Rate for Payer: Cash Price |
$239.82
|
| Rate for Payer: Cofinity Commercial |
$257.81
|
| Rate for Payer: Cofinity Commercial |
$209.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$269.80
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.81
|
| Rate for Payer: Nomi Health Commercial |
$503.70
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$254.81
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.71
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$422.17
|
| Rate for Payer: Priority Health SBD |
$188.86
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$94.53
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
IP
|
$299.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$188.86 |
| Max. Negotiated Rate |
$269.80 |
| Rate for Payer: Aetna Commercial |
$254.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.86
|
| Rate for Payer: Cash Price |
$239.82
|
| Rate for Payer: Cofinity Commercial |
$209.85
|
| Rate for Payer: Cofinity Commercial |
$257.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.82
|
| Rate for Payer: Healthscope Commercial |
$269.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.81
|
| Rate for Payer: PHP Commercial |
$254.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.86
|
| Rate for Payer: Priority Health SBD |
$188.86
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$213.28
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$1,107.72 |
| Rate for Payer: Aetna Commercial |
$181.29
|
| Rate for Payer: Aetna Medicare |
$366.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$16.19
|
| Rate for Payer: BCN Commercial |
$16.19
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$183.42
|
| Rate for Payer: Cofinity Commercial |
$149.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$191.95
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$1,057.35
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$181.29
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.72
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$886.18
|
| Rate for Payer: Priority Health SBD |
$134.37
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$992.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$198.43
|
| Rate for Payer: VA VA |
$352.45
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$213.28
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$134.37 |
| Max. Negotiated Rate |
$191.95 |
| Rate for Payer: Aetna Commercial |
$181.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.63
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$149.30
|
| Rate for Payer: Cofinity Commercial |
$183.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Healthscope Commercial |
$191.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: PHP Commercial |
$181.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: Priority Health SBD |
$134.37
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
OP
|
$93.84
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$84.46 |
| Rate for Payer: Aetna Commercial |
$79.76
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$80.70
|
| Rate for Payer: Cofinity Commercial |
$65.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$84.46
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.76
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$79.76
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.49
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$12.39
|
| Rate for Payer: Priority Health SBD |
$59.12
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.47
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
IP
|
$93.84
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.12 |
| Max. Negotiated Rate |
$84.46 |
| Rate for Payer: Aetna Commercial |
$79.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.00
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$65.69
|
| Rate for Payer: Cofinity Commercial |
$80.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.07
|
| Rate for Payer: Healthscope Commercial |
$84.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.76
|
| Rate for Payer: PHP Commercial |
$79.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.00
|
| Rate for Payer: Priority Health SBD |
$59.12
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: BCBS Complete |
$9.58
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$15.07
|
| Rate for Payer: BCN Commercial |
$15.07
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$9.13
|
| Rate for Payer: Mclaren Medicare |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$9.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$25.54
|
| Rate for Payer: PACE Medicare |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.03
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health Narrow Network |
$13.62
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: VA VA |
$17.03
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health SBD |
$29.50
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
OP
|
$34.33
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: Aetna Medicare |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.36
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.49
|
| Rate for Payer: BCBS Trust/PPO |
$13.72
|
| Rate for Payer: BCN Commercial |
$13.72
|
| Rate for Payer: BCN Medicare Advantage |
$15.49
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Cofinity Commercial |
$24.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Mclaren Medicaid |
$8.30
|
| Rate for Payer: Mclaren Medicare |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.18
|
| Rate for Payer: Nomi Health Commercial |
$23.24
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.49
|
| Rate for Payer: PHP Commercial |
$29.18
|
| Rate for Payer: PHP Medicare Advantage |
$15.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.94
|
| Rate for Payer: Priority Health Medicare |
$15.49
|
| Rate for Payer: Priority Health Narrow Network |
$12.75
|
| Rate for Payer: Priority Health SBD |
$21.63
|
| Rate for Payer: Railroad Medicare Medicare |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.49
|
| Rate for Payer: UHC Medicare Advantage |
$15.49
|
| Rate for Payer: UHCCP Medicaid |
$8.72
|
| Rate for Payer: VA VA |
$15.49
|
|
