|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
IP
|
$31.06
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.57 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$26.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.19
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cofinity Advantage |
$21.74
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.85
|
| Rate for Payer: Healthscope Commercial |
$27.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.30
|
| Rate for Payer: PHP Commercial |
$26.40
|
| Rate for Payer: Priority Health SBD |
$19.57
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
OP
|
$31.06
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$26.40
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.71
|
| Rate for Payer: BCBS Complete |
$4.27
|
| Rate for Payer: BCBS MAPPO |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$8.29
|
| Rate for Payer: BCN Commercial |
$8.29
|
| Rate for Payer: BCN Medicare Advantage |
$7.77
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cofinity Advantage |
$21.74
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.77
|
| Rate for Payer: Healthscope Commercial |
$27.95
|
| Rate for Payer: Mclaren Medicaid |
$4.06
|
| Rate for Payer: Mclaren Medicare |
$7.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.16
|
| Rate for Payer: Meridian Medicaid |
$8.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.40
|
| Rate for Payer: Nomi Health Commercial |
$11.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.30
|
| Rate for Payer: PACE Medicare |
$7.38
|
| Rate for Payer: PACE SWMI |
$7.77
|
| Rate for Payer: PHP Commercial |
$26.40
|
| Rate for Payer: PHP Medicare Advantage |
$7.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.77
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health SBD |
$19.57
|
| Rate for Payer: Priority Health Tiered Network |
$6.22
|
| Rate for Payer: Railroad Medicare Medicare |
$7.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.66
|
| Rate for Payer: UHC Core |
$11.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.77
|
| Rate for Payer: UHC Exchange |
$11.66
|
| Rate for Payer: UHC Medicaid |
$4.06
|
| Rate for Payer: UHCCP Medicaid |
$4.06
|
| Rate for Payer: VA VA |
$7.77
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$6.89
|
| Rate for Payer: BCN Commercial |
$6.89
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Mclaren Medicaid |
$3.38
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.47
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.71
|
| Rate for Payer: UHC Core |
$9.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.03 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health SBD |
$12.03
|
|
|
HC C DIFFICILE PCR
|
Facility
|
IP
|
$143.47
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.39 |
| Max. Negotiated Rate |
$129.12 |
| Rate for Payer: Aetna Commercial |
$121.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.26
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cofinity Advantage |
$100.43
|
| Rate for Payer: Cofinity Commercial |
$123.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.78
|
| Rate for Payer: Healthscope Commercial |
$129.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.60
|
| Rate for Payer: PHP Commercial |
$121.95
|
| Rate for Payer: Priority Health SBD |
$90.39
|
|
|
HC C DIFFICILE PCR
|
Facility
|
OP
|
$143.47
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$129.12 |
| Rate for Payer: Aetna Commercial |
$121.95
|
| Rate for Payer: Aetna Medicare |
$38.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.59
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$37.27
|
| Rate for Payer: BCBS Trust/PPO |
$39.73
|
| Rate for Payer: BCN Commercial |
$39.73
|
| Rate for Payer: BCN Medicare Advantage |
$37.27
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cofinity Advantage |
$100.43
|
| Rate for Payer: Cofinity Commercial |
$123.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.27
|
| Rate for Payer: Healthscope Commercial |
$129.12
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$37.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.13
|
| Rate for Payer: Meridian Medicaid |
$39.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.95
|
| Rate for Payer: Nomi Health Commercial |
$55.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.60
|
| Rate for Payer: PACE Medicare |
$35.41
|
| Rate for Payer: PACE SWMI |
$37.27
|
| Rate for Payer: PHP Commercial |
$121.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37.27
|
| Rate for Payer: Priority Health Medicare |
$37.27
|
| Rate for Payer: Priority Health SBD |
$90.39
|
| Rate for Payer: Priority Health Tiered Network |
$29.82
|
| Rate for Payer: Railroad Medicare Medicare |
$37.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.91
|
| Rate for Payer: UHC Core |
$55.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.27
|
| Rate for Payer: UHC Exchange |
$55.91
|
| Rate for Payer: UHC Medicaid |
$19.49
|
| Rate for Payer: UHCCP Medicaid |
$19.49
|
| Rate for Payer: VA VA |
$37.27
|
|
|
HC C DIFF TOXIN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$6.27
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC C DIFF TOXIN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$133.38
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$120.04 |
| Rate for Payer: Aetna Commercial |
$113.37
|
| Rate for Payer: Aetna Medicare |
$19.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$20.22
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Advantage |
$93.37
|
| Rate for Payer: Cofinity Commercial |
$114.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$120.04
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Nomi Health Commercial |
$28.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$113.37
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.96
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health SBD |
$84.03
|
| Rate for Payer: Priority Health Tiered Network |
$15.17
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.44
|
| Rate for Payer: UHC Core |
$28.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.96
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.96
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$133.38
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.03 |
| Max. Negotiated Rate |
$120.04 |
| Rate for Payer: Aetna Commercial |
$113.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Advantage |
$93.37
|
| Rate for Payer: Cofinity Commercial |
$114.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Healthscope Commercial |
$120.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PHP Commercial |
$113.37
|
| Rate for Payer: Priority Health SBD |
$84.03
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$188.06
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.48 |
| Max. Negotiated Rate |
$169.25 |
| Rate for Payer: Aetna Commercial |
$159.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.24
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cofinity Advantage |
$131.64
|
| Rate for Payer: Cofinity Commercial |
$161.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.45
|
| Rate for Payer: Healthscope Commercial |
$169.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.04
|
| Rate for Payer: PHP Commercial |
$159.85
|
| Rate for Payer: Priority Health SBD |
$118.48
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$188.06
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$169.25 |
| Rate for Payer: Aetna Commercial |
$159.85
|
| Rate for Payer: Aetna Medicare |
$19.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$20.22
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cofinity Advantage |
$131.64
|
| Rate for Payer: Cofinity Commercial |
$161.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$169.25
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.85
|
| Rate for Payer: Nomi Health Commercial |
$28.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.04
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$159.85
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.96
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health SBD |
$118.48
|
| Rate for Payer: Priority Health Tiered Network |
$15.17
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.44
|
| Rate for Payer: UHC Core |
$28.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.96
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.96
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$137.84 |
| Max. Negotiated Rate |
$196.92 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.22
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Advantage |
$153.16
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: Priority Health SBD |
$137.84
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$194.55
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$122.57 |
| Max. Negotiated Rate |
$175.09 |
| Rate for Payer: Aetna Commercial |
$165.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.46
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cofinity Advantage |
$136.19
|
| Rate for Payer: Cofinity Commercial |
$167.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.64
|
| Rate for Payer: Healthscope Commercial |
$175.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.91
|
| Rate for Payer: PHP Commercial |
$165.37
|
| Rate for Payer: Priority Health SBD |
$122.57
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$194.55
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$175.09 |
| Rate for Payer: Aetna Commercial |
$165.37
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$14.17
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$27.52
|
| Rate for Payer: BCN Commercial |
$27.52
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cofinity Advantage |
$136.19
|
| Rate for Payer: Cofinity Commercial |
$167.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$175.09
|
| Rate for Payer: Mclaren Medicaid |
$13.50
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$27.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.37
|
| Rate for Payer: Nomi Health Commercial |
$38.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.91
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$165.37
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.81
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health SBD |
$122.57
|
| Rate for Payer: Priority Health Tiered Network |
$20.65
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$38.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.81
|
| Rate for Payer: UHC Exchange |
$38.72
|
| Rate for Payer: UHC Medicaid |
$13.50
|
| Rate for Payer: UHCCP Medicaid |
$13.50
|
| Rate for Payer: VA VA |
$25.81
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$366.66 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna Medicare |
$127.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: BCBS Complete |
$67.12
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$130.32
|
| Rate for Payer: BCN Commercial |
$130.32
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Advantage |
$153.16
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Mclaren Medicaid |
$63.92
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: Meridian Medicaid |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$366.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$122.22
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health SBD |
$137.84
|
| Rate for Payer: Priority Health Tiered Network |
$97.78
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.33
|
| Rate for Payer: UHC Core |
$183.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.22
|
| Rate for Payer: UHC Exchange |
$183.33
|
| Rate for Payer: UHC Medicaid |
$63.92
|
| Rate for Payer: UHCCP Medicaid |
$63.92
|
| Rate for Payer: VA VA |
$122.22
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$137.84 |
| Max. Negotiated Rate |
$196.92 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.22
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Advantage |
$153.16
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: Priority Health SBD |
$137.84
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$366.66 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna Medicare |
$127.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: BCBS Complete |
$67.12
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$130.32
|
| Rate for Payer: BCN Commercial |
$130.32
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Advantage |
$153.16
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Mclaren Medicaid |
$63.92
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: Meridian Medicaid |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$366.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$122.22
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health SBD |
$137.84
|
| Rate for Payer: Priority Health Tiered Network |
$97.78
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.33
|
| Rate for Payer: UHC Core |
$183.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.22
|
| Rate for Payer: UHC Exchange |
$183.33
|
| Rate for Payer: UHC Medicaid |
$63.92
|
| Rate for Payer: UHCCP Medicaid |
$63.92
|
| Rate for Payer: VA VA |
$122.22
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health SBD |
$18.26
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health SBD |
$18.26
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.37 |
| Max. Negotiated Rate |
$1,111.95 |
| Rate for Payer: Aetna Commercial |
$1,050.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.08
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Advantage |
$864.85
|
| Rate for Payer: Cofinity Commercial |
$1,062.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Healthscope Commercial |
$1,111.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PHP Commercial |
$1,050.17
|
| Rate for Payer: Priority Health SBD |
$778.37
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna Commercial |
$1,050.17
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$858.11
|
| Rate for Payer: BCN Commercial |
$858.11
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Advantage |
$864.85
|
| Rate for Payer: Cofinity Commercial |
$1,062.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,111.95
|
| Rate for Payer: Mclaren Medicaid |
$460.91
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,050.17
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$778.37
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: Aetna Medicare |
$12.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.57
|
| Rate for Payer: BCBS Complete |
$6.84
|
| Rate for Payer: BCBS MAPPO |
$12.46
|
| Rate for Payer: BCBS Trust/PPO |
$13.29
|
| Rate for Payer: BCN Commercial |
$13.29
|
| Rate for Payer: BCN Medicare Advantage |
$12.46
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Advantage |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.46
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Mclaren Medicaid |
$6.52
|
| Rate for Payer: Mclaren Medicare |
$12.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.08
|
| Rate for Payer: Meridian Medicaid |
$13.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$18.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: PACE Medicare |
$11.84
|
| Rate for Payer: PACE SWMI |
$12.46
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: PHP Medicare Advantage |
$12.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.46
|
| Rate for Payer: Priority Health Medicare |
$12.46
|
| Rate for Payer: Priority Health SBD |
$110.12
|
| Rate for Payer: Priority Health Tiered Network |
$9.97
|
| Rate for Payer: Railroad Medicare Medicare |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC Core |
$18.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.46
|
| Rate for Payer: UHC Exchange |
$18.69
|
| Rate for Payer: UHC Medicaid |
$6.52
|
| Rate for Payer: UHCCP Medicaid |
$6.52
|
| Rate for Payer: VA VA |
$12.46
|
|
