|
HC ENTEROVIRUS
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$204.00
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$206.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.00
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$204.00
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$151.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$204.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$206.40
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.00
|
| Rate for Payer: PHP Commercial |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health SBD |
$151.20
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
OP
|
$201.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$181.53 |
| Rate for Payer: Aetna Commercial |
$171.44
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$161.36
|
| Rate for Payer: Cash Price |
$161.36
|
| Rate for Payer: Cofinity Commercial |
$141.19
|
| Rate for Payer: Cofinity Commercial |
$173.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$181.53
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.44
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$171.44
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.19
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$127.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
IP
|
$201.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$127.07 |
| Max. Negotiated Rate |
$181.53 |
| Rate for Payer: Aetna Commercial |
$171.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.10
|
| Rate for Payer: Cash Price |
$161.36
|
| Rate for Payer: Cofinity Commercial |
$141.19
|
| Rate for Payer: Cofinity Commercial |
$173.46
|
| Rate for Payer: Healthscope Commercial |
$181.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.44
|
| Rate for Payer: PHP Commercial |
$171.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.19
|
| Rate for Payer: Priority Health SBD |
$127.07
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Cofinity Commercial |
$67.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$61.05
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$61.05 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.98
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$67.83
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health SBD |
$61.05
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.93
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.30
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.77
|
| Rate for Payer: Priority Health SBD |
$23.20
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$4.95
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$6.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Mclaren Medicaid |
$4.72
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Medicaid |
$4.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.30
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.77
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health SBD |
$23.20
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC Core |
$14.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Exchange |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC ENZYME DETECTION
|
Facility
|
OP
|
$28.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$24.40
|
| Rate for Payer: Aetna Medicare |
$4.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.73
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$3.72
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$22.96
|
| Rate for Payer: Cash Price |
$22.96
|
| Rate for Payer: Cofinity Commercial |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$20.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$25.83
|
| Rate for Payer: Mclaren Medicaid |
$2.60
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$2.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.40
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$24.40
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.09
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health SBD |
$18.08
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.70
|
| Rate for Payer: UHC Core |
$8.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Exchange |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$4.89
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$28.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.08 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$24.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.66
|
| Rate for Payer: Cash Price |
$22.96
|
| Rate for Payer: Cofinity Commercial |
$20.09
|
| Rate for Payer: Cofinity Commercial |
$24.68
|
| Rate for Payer: Healthscope Commercial |
$25.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.40
|
| Rate for Payer: PHP Commercial |
$24.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.09
|
| Rate for Payer: Priority Health SBD |
$18.08
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$2,040.47 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: Aetna Medicare |
$795.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$956.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$956.40
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$765.12
|
| Rate for Payer: BCBS Trust/PPO |
$134.87
|
| Rate for Payer: BCN Medicare Advantage |
$765.12
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$113.40
|
| Rate for Payer: Cofinity Commercial |
$139.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.12
|
| Rate for Payer: Healthscope Commercial |
$145.80
|
| Rate for Payer: Mclaren Medicaid |
$418.52
|
| Rate for Payer: Mclaren Medicare |
$765.12
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$803.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$879.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$137.70
|
| Rate for Payer: PACE Medicare |
$726.86
|
| Rate for Payer: PACE SWMI |
$765.12
|
| Rate for Payer: PHP Commercial |
$137.70
|
| Rate for Payer: PHP Medicare Advantage |
$765.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,040.47
|
| Rate for Payer: Priority Health Medicare |
$765.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.38
|
| Rate for Payer: Priority Health SBD |
$102.06
|
| Rate for Payer: Railroad Medicare Medicare |
$765.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.68
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.12
|
| Rate for Payer: UHC Exchange |
$134.25
|
| Rate for Payer: UHC Medicare Advantage |
$788.07
|
| Rate for Payer: VA VA |
$765.12
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$102.06 |
| Max. Negotiated Rate |
$145.80 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.30
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$113.40
|
| Rate for Payer: Cofinity Commercial |
$139.32
|
| Rate for Payer: Healthscope Commercial |
$145.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$137.70
|
| Rate for Payer: PHP Commercial |
$137.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health SBD |
$102.06
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$45.40
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.51
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$31.78
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health SBD |
$28.60
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$45.40
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna Medicare |
$6.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.24
|
| Rate for Payer: BCBS Complete |
$3.33
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$4.53
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$31.78
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Mclaren Medicaid |
$3.17
|
| Rate for Payer: Mclaren Medicare |
$5.79
|
| Rate for Payer: Meridian Medicaid |
$3.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PACE Medicare |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health SBD |
$28.60
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.95
|
| Rate for Payer: UHC Core |
$8.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.79
|
| Rate for Payer: UHC Exchange |
$5.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.96
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$30.70
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.34 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.96
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cofinity Commercial |
$21.49
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Healthscope Commercial |
$27.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.10
|
| Rate for Payer: PHP Commercial |
$26.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.49
|
| Rate for Payer: Priority Health SBD |
$19.34
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$30.70
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.96
|
| Rate for Payer: BCBS Complete |
$12.28
|
| Rate for Payer: BCBS Trust/PPO |
$15.66
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cofinity Commercial |
$21.49
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Healthscope Commercial |
$27.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.10
|
| Rate for Payer: PHP Commercial |
$26.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.49
|
| Rate for Payer: Priority Health SBD |
$19.34
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$170.29 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health SBD |
$170.29
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$108.12 |
| Max. Negotiated Rate |
$875.72 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: BCBS Complete |
$108.12
|
| Rate for Payer: BCBS Trust/PPO |
$875.72
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.97
|
| Rate for Payer: UHC Exchange |
$368.31
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
IP
|
$17,391.67
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,956.75 |
| Max. Negotiated Rate |
$15,652.50 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,304.59
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$12,174.17
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health SBD |
$10,956.75
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
OP
|
$17,391.67
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$799.61 |
| Max. Negotiated Rate |
$26,416.19 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: Aetna Medicare |
$21,978.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,304.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,416.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,416.19
|
| Rate for Payer: BCBS Complete |
$12,138.77
|
| Rate for Payer: BCBS MAPPO |
$21,132.95
|
| Rate for Payer: BCBS Trust/PPO |
$977.86
|
| Rate for Payer: BCN Medicare Advantage |
$21,132.95
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$12,174.17
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,132.95
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Mclaren Medicaid |
$11,559.72
|
| Rate for Payer: Mclaren Medicare |
$21,132.95
|
| Rate for Payer: Meridian Medicaid |
$12,138.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,189.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,302.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PACE Medicare |
$20,076.30
|
| Rate for Payer: PACE SWMI |
$21,132.95
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: PHP Medicare Advantage |
$21,132.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,559.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health Medicare |
$21,132.95
|
| Rate for Payer: Priority Health SBD |
$10,956.75
|
| Rate for Payer: Railroad Medicare Medicare |
$21,132.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$879.57
|
| Rate for Payer: UHC Core |
$10,600.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,132.95
|
| Rate for Payer: UHC Exchange |
$799.61
|
| Rate for Payer: UHC Medicare Advantage |
$21,766.94
|
| Rate for Payer: VA VA |
$21,132.95
|
|
|
HC EP+ABL VT
|
Facility
|
IP
|
$17,391.67
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,956.75 |
| Max. Negotiated Rate |
$15,652.50 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,304.59
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Cofinity Commercial |
$12,174.17
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health SBD |
$10,956.75
|
|
|
HC EP+ABL VT
|
Facility
|
OP
|
$17,391.67
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$963.33 |
| Max. Negotiated Rate |
$26,416.19 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: Aetna Medicare |
$21,978.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,304.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,416.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,416.19
|
| Rate for Payer: BCBS Complete |
$12,138.77
|
| Rate for Payer: BCBS MAPPO |
$21,132.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.34
|
| Rate for Payer: BCN Medicare Advantage |
$21,132.95
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$12,174.17
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,132.95
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Mclaren Medicaid |
$11,559.72
|
| Rate for Payer: Mclaren Medicare |
$21,132.95
|
| Rate for Payer: Meridian Medicaid |
$12,138.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,189.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,302.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PACE Medicare |
$20,076.30
|
| Rate for Payer: PACE SWMI |
$21,132.95
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: PHP Medicare Advantage |
$21,132.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,559.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health Medicare |
$21,132.95
|
| Rate for Payer: Priority Health SBD |
$10,956.75
|
| Rate for Payer: Railroad Medicare Medicare |
$21,132.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.66
|
| Rate for Payer: UHC Core |
$10,600.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,132.95
|
| Rate for Payer: UHC Exchange |
$963.33
|
| Rate for Payer: UHC Medicare Advantage |
$21,766.94
|
| Rate for Payer: VA VA |
$21,132.95
|
|
|
HC EP AFTER DRUGS
|
Facility
|
IP
|
$7,278.36
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,585.37 |
| Max. Negotiated Rate |
$6,550.52 |
| Rate for Payer: Aetna Commercial |
$6,186.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,730.93
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$5,094.85
|
| Rate for Payer: Cofinity Commercial |
$6,259.39
|
| Rate for Payer: Healthscope Commercial |
$6,550.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: PHP Commercial |
$6,186.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: Priority Health SBD |
$4,585.37
|
|
