|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$27.42
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.82
|
| Rate for Payer: Cash Price |
$21.94
|
| Rate for Payer: Cofinity Advantage |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.94
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.57
|
| Rate for Payer: PHP Commercial |
$23.31
|
| Rate for Payer: Priority Health SBD |
$17.27
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$19.26
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$17.33 |
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.52
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Cofinity Advantage |
$13.48
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$17.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.45
|
| Rate for Payer: PHP Commercial |
$16.37
|
| Rate for Payer: Priority Health SBD |
$12.13
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$19.26
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$17.33 |
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: Aetna Medicare |
$9.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.52
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Cofinity Advantage |
$13.48
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$17.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.45
|
| Rate for Payer: PHP Commercial |
$16.37
|
| Rate for Payer: Priority Health SBD |
$12.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.52
|
| Rate for Payer: UHC Core |
$10.03
|
| Rate for Payer: UHC Exchange |
$7.57
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.16
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$2.70
|
| Rate for Payer: Mclaren Medicare |
$5.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: Meridian Medicaid |
$5.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$7.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.90
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.16
|
| Rate for Payer: Priority Health Medicare |
$5.16
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$4.13
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.74
|
| Rate for Payer: UHC Core |
$7.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.16
|
| Rate for Payer: UHC Exchange |
$7.74
|
| Rate for Payer: UHC Medicaid |
$2.70
|
| Rate for Payer: UHCCP Medicaid |
$2.70
|
| Rate for Payer: VA VA |
$5.16
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.61 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Advantage |
$38.46
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health SBD |
$34.61
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$6.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.54
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$6.03
|
| Rate for Payer: BCBS Trust/PPO |
$6.43
|
| Rate for Payer: BCN Commercial |
$6.43
|
| Rate for Payer: BCN Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Advantage |
$38.46
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.03
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Mclaren Medicare |
$6.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.33
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$9.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PACE Medicare |
$5.73
|
| Rate for Payer: PACE SWMI |
$6.03
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$6.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.03
|
| Rate for Payer: Priority Health Medicare |
$6.03
|
| Rate for Payer: Priority Health SBD |
$34.61
|
| Rate for Payer: Priority Health Tiered Network |
$4.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.05
|
| Rate for Payer: UHC Core |
$9.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.03
|
| Rate for Payer: UHC Exchange |
$9.05
|
| Rate for Payer: UHC Medicaid |
$3.15
|
| Rate for Payer: UHCCP Medicaid |
$3.15
|
| Rate for Payer: VA VA |
$6.03
|
|
|
HC CALCULI
|
Facility
|
OP
|
$43.51
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$13.76
|
| Rate for Payer: BCN Commercial |
$13.76
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Advantage |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.90
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health SBD |
$27.41
|
| Rate for Payer: Priority Health Tiered Network |
$10.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.35
|
| Rate for Payer: UHC Core |
$19.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.90
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicaid |
$6.75
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC CALCULI
|
Facility
|
IP
|
$43.51
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.41 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.28
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Advantage |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health SBD |
$27.41
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$29.99 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$29.99
|
| Rate for Payer: BCN Commercial |
$29.99
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.27
|
| Rate for Payer: UHC Core |
$246.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$185.78
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$297.81 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health SBD |
$297.81
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$297.81 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health SBD |
$297.81
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$53.16 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$53.16
|
| Rate for Payer: BCN Commercial |
$53.16
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.27
|
| Rate for Payer: UHC Core |
$246.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$185.78
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$217.23 |
| Rate for Payer: Aetna Commercial |
$205.16
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.93
|
| Rate for Payer: BCN Commercial |
$20.93
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Advantage |
$168.96
|
| Rate for Payer: Cofinity Commercial |
$207.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$217.23
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$20.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Nomi Health Commercial |
$29.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$205.16
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.63
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health SBD |
$152.06
|
| Rate for Payer: Priority Health Tiered Network |
$15.70
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.45
|
| Rate for Payer: UHC Core |
$29.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.63
|
| Rate for Payer: UHC Exchange |
$29.45
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$19.63
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$152.06 |
| Max. Negotiated Rate |
$217.23 |
| Rate for Payer: Aetna Commercial |
$205.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.89
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Advantage |
$168.96
|
| Rate for Payer: Cofinity Commercial |
$207.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Healthscope Commercial |
$217.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PHP Commercial |
$205.16
|
| Rate for Payer: Priority Health SBD |
$152.06
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health SBD |
$26.22
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.93
|
| Rate for Payer: BCN Commercial |
$20.93
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$20.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$29.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.63
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Priority Health Tiered Network |
$15.70
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.45
|
| Rate for Payer: UHC Core |
$29.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.63
|
| Rate for Payer: UHC Exchange |
$29.45
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$19.63
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$686.70
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$432.62 |
| Max. Negotiated Rate |
$618.03 |
| Rate for Payer: Aetna Commercial |
$583.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.36
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cofinity Advantage |
$480.69
|
| Rate for Payer: Cofinity Commercial |
$590.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.36
|
| Rate for Payer: Healthscope Commercial |
$618.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.02
|
| Rate for Payer: PHP Commercial |
$583.70
|
| Rate for Payer: Priority Health SBD |
$432.62
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$686.70
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.61 |
| Max. Negotiated Rate |
$618.03 |
| Rate for Payer: Aetna Commercial |
$583.70
|
| Rate for Payer: Aetna Medicare |
$126.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$129.68
|
| Rate for Payer: BCN Commercial |
$129.68
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cofinity Advantage |
$480.69
|
| Rate for Payer: Cofinity Commercial |
$590.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$618.03
|
| Rate for Payer: Mclaren Medicaid |
$63.61
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: Meridian Medicaid |
$127.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Nomi Health Commercial |
$364.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.02
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$583.70
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$121.63
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health SBD |
$432.62
|
| Rate for Payer: Priority Health Tiered Network |
$97.30
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.45
|
| Rate for Payer: UHC Core |
$182.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.63
|
| Rate for Payer: UHC Exchange |
$182.45
|
| Rate for Payer: UHC Medicaid |
$63.61
|
| Rate for Payer: UHCCP Medicaid |
$63.61
|
| Rate for Payer: VA VA |
$121.63
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$134.24
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.13 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: Aetna Medicare |
$67.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.26
|
| Rate for Payer: BCBS Complete |
$53.70
|
| Rate for Payer: BCBS Trust/PPO |
$57.71
|
| Rate for Payer: BCN Commercial |
$57.71
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Advantage |
$93.97
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: PHP Commercial |
$114.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58.91
|
| Rate for Payer: Priority Health SBD |
$84.57
|
| Rate for Payer: Priority Health Tiered Network |
$47.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.26
|
| Rate for Payer: UHC Core |
$69.94
|
| Rate for Payer: UHC Exchange |
$52.76
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$134.24
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.26
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Advantage |
$93.97
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: PHP Commercial |
$114.10
|
| Rate for Payer: Priority Health SBD |
$84.57
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$22.19
|
| Rate for Payer: BCN Commercial |
$22.19
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$21.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$31.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.81
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: Priority Health Tiered Network |
$16.65
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.22
|
| Rate for Payer: UHC Core |
$31.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$31.22
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health SBD |
$31.42
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$22.19
|
| Rate for Payer: BCN Commercial |
$22.19
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$21.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$31.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.81
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: Priority Health Tiered Network |
$16.65
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.22
|
| Rate for Payer: UHC Core |
$31.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$31.22
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.42 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health SBD |
$29.42
|
|
