|
HC CHLORIDE OTHER SOURCE
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health SBD |
$13.63
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$5.33
|
| Rate for Payer: BCN Commercial |
$5.33
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Mclaren Medicaid |
$2.62
|
| Rate for Payer: Mclaren Medicare |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$7.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PACE Medicare |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.00
|
| Rate for Payer: Priority Health Medicare |
$5.00
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: Priority Health Tiered Network |
$4.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.50
|
| Rate for Payer: UHC Core |
$7.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.00
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: VA VA |
$5.00
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health SBD |
$13.63
|
|
|
HC CHLORIDE SERUM
|
Facility
|
IP
|
$22.07
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.90 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Advantage |
$15.45
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: Priority Health SBD |
$13.90
|
|
|
HC CHLORIDE SERUM
|
Facility
|
OP
|
$22.07
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: Aetna Medicare |
$4.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.75
|
| Rate for Payer: BCBS Complete |
$2.53
|
| Rate for Payer: BCBS MAPPO |
$4.60
|
| Rate for Payer: BCN Medicare Advantage |
$4.60
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Advantage |
$15.45
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.60
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Mclaren Medicaid |
$2.41
|
| Rate for Payer: Mclaren Medicare |
$4.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.83
|
| Rate for Payer: Meridian Medicaid |
$4.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Nomi Health Commercial |
$6.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PACE Medicare |
$4.37
|
| Rate for Payer: PACE SWMI |
$4.60
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.60
|
| Rate for Payer: Priority Health Medicare |
$4.60
|
| Rate for Payer: Priority Health SBD |
$13.90
|
| Rate for Payer: Priority Health Tiered Network |
$3.68
|
| Rate for Payer: Railroad Medicare Medicare |
$4.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.90
|
| Rate for Payer: UHC Core |
$6.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.60
|
| Rate for Payer: UHC Exchange |
$6.90
|
| Rate for Payer: UHC Medicaid |
$2.41
|
| Rate for Payer: UHCCP Medicaid |
$2.41
|
| Rate for Payer: VA VA |
$4.60
|
|
|
HC CHLORIDE URINE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
30100153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.84 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
|
|
HC CHLORIDE URINE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
30100153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$5.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.19
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS MAPPO |
$5.75
|
| Rate for Payer: BCBS Trust/PPO |
$6.13
|
| Rate for Payer: BCN Commercial |
$6.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.75
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Mclaren Medicaid |
$3.01
|
| Rate for Payer: Mclaren Medicare |
$5.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$8.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$5.46
|
| Rate for Payer: PACE SWMI |
$5.75
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.75
|
| Rate for Payer: Priority Health Medicare |
$5.75
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$4.60
|
| Rate for Payer: Railroad Medicare Medicare |
$5.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.63
|
| Rate for Payer: UHC Core |
$8.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.75
|
| Rate for Payer: UHC Exchange |
$8.63
|
| Rate for Payer: UHC Medicaid |
$3.01
|
| Rate for Payer: UHCCP Medicaid |
$3.01
|
| Rate for Payer: VA VA |
$5.75
|
|
|
HC CHLOROZINE BATH
|
Facility
|
IP
|
$4.57
|
|
| Hospital Charge Code |
27000094
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.97
|
| Rate for Payer: Cash Price |
$3.66
|
| Rate for Payer: Cofinity Advantage |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.66
|
| Rate for Payer: Healthscope Commercial |
$4.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.88
|
| Rate for Payer: Priority Health SBD |
$2.88
|
|
|
HC CHLOROZINE BATH
|
Facility
|
OP
|
$4.57
|
|
| Hospital Charge Code |
27000094
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna Commercial |
$3.88
|
| Rate for Payer: Aetna Medicare |
$2.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.97
|
| Rate for Payer: BCBS Complete |
$1.83
|
| Rate for Payer: Cash Price |
$3.66
|
| Rate for Payer: Cofinity Advantage |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.66
|
| Rate for Payer: Healthscope Commercial |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.88
|
| Rate for Payer: Priority Health SBD |
$2.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.97
|
| Rate for Payer: UHC Core |
$2.38
|
| Rate for Payer: UHC Exchange |
$1.80
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE EXISTING ACCESS
|
Facility
|
IP
|
$600.96
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
36100488
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$378.60 |
| Max. Negotiated Rate |
$540.86 |
| Rate for Payer: Aetna Commercial |
$510.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.62
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cofinity Advantage |
$420.67
|
| Rate for Payer: Cofinity Commercial |
$516.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.77
|
| Rate for Payer: Healthscope Commercial |
$540.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.72
|
| Rate for Payer: PHP Commercial |
$510.82
|
| Rate for Payer: Priority Health SBD |
$378.60
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE EXISTING ACCESS
|
Facility
|
OP
|
$600.96
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
36100488
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$378.60 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Commercial |
$510.82
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$629.09
|
| Rate for Payer: BCN Commercial |
$629.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cofinity Advantage |
$420.67
|
| Rate for Payer: Cofinity Commercial |
$516.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$540.86
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.82
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.72
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$510.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$378.60
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE NEW ACCESS
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
CPT 47532
|
| Hospital Charge Code |
36100489
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,965.49
|
| Rate for Payer: BCN Commercial |
$1,965.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Advantage |
$2,629.69
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$2,366.72
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE NEW ACCESS
|
Facility
|
IP
|
$3,756.70
|
|
|
Service Code
|
CPT 47532
|
| Hospital Charge Code |
36100489
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,366.72 |
| Max. Negotiated Rate |
$3,381.03 |
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.86
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Advantage |
$2,629.69
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: Priority Health SBD |
$2,366.72
|
|
|
HC CHOLESTEROL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100155
|
|
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 CHOLESTEROL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100155
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: BCBS Complete |
$2.39
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| 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 |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$2.28
|
| Rate for Payer: Mclaren Medicare |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$4.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.13
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.35
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$3.48
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.53
|
| Rate for Payer: UHC Core |
$6.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.35
|
| Rate for Payer: UHC Exchange |
$6.53
|
| Rate for Payer: UHC Medicaid |
$2.28
|
| Rate for Payer: UHCCP Medicaid |
$2.28
|
| Rate for Payer: VA VA |
$4.35
|
|
|
HC CHOLESTEROL, TOTAL LMPP
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100688
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
|
|
HC CHOLESTEROL, TOTAL LMPP
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100688
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: BCBS Complete |
$2.39
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Mclaren Medicaid |
$2.28
|
| Rate for Payer: Mclaren Medicare |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$4.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Medicare |
$4.13
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.35
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$3.48
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.53
|
| Rate for Payer: UHC Core |
$6.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.35
|
| Rate for Payer: UHC Exchange |
$6.53
|
| Rate for Payer: UHC Medicaid |
$2.28
|
| Rate for Payer: UHCCP Medicaid |
$2.28
|
| Rate for Payer: VA VA |
$4.35
|
|
|
HC CHOLETEC PER STUDY
|
Facility
|
OP
|
$473.22
|
|
|
Service Code
|
HCPCS A9537
|
| Hospital Charge Code |
34300003
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$425.90 |
| Rate for Payer: Aetna Commercial |
$402.24
|
| Rate for Payer: Aetna Medicare |
$236.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.59
|
| Rate for Payer: BCBS Complete |
$189.29
|
| Rate for Payer: BCBS Trust/PPO |
$99.21
|
| Rate for Payer: BCN Commercial |
$99.21
|
| Rate for Payer: Cash Price |
$378.58
|
| Rate for Payer: Cash Price |
$378.58
|
| Rate for Payer: Cofinity Advantage |
$331.25
|
| Rate for Payer: Cofinity Commercial |
$406.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.58
|
| Rate for Payer: Healthscope Commercial |
$425.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.92
|
| Rate for Payer: PHP Commercial |
$402.24
|
| Rate for Payer: Priority Health SBD |
$298.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.21
|
| Rate for Payer: UHC Core |
$187.21
|
| Rate for Payer: UHC Exchange |
$187.21
|
|
|
HC CHOLETEC PER STUDY
|
Facility
|
IP
|
$473.22
|
|
|
Service Code
|
HCPCS A9537
|
| Hospital Charge Code |
34300003
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$298.13 |
| Max. Negotiated Rate |
$425.90 |
| Rate for Payer: Aetna Commercial |
$402.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.59
|
| Rate for Payer: Cash Price |
$378.58
|
| Rate for Payer: Cofinity Advantage |
$331.25
|
| Rate for Payer: Cofinity Commercial |
$406.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.58
|
| Rate for Payer: Healthscope Commercial |
$425.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.92
|
| Rate for Payer: PHP Commercial |
$402.24
|
| Rate for Payer: Priority Health SBD |
$298.13
|
|
|
HC CHOLINESTERASE RBC
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
30100157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Advantage |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health SBD |
$42.61
|
|
|
HC CHOLINESTERASE RBC
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
30100157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.26
|
| Rate for Payer: BCBS Complete |
$5.39
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$10.46
|
| Rate for Payer: BCN Commercial |
$10.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Advantage |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$5.13
|
| Rate for Payer: Mclaren Medicare |
$9.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.30
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$14.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Medicare |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.81
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Priority Health Tiered Network |
$7.85
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.72
|
| Rate for Payer: UHC Core |
$14.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.81
|
| Rate for Payer: UHC Exchange |
$14.72
|
| Rate for Payer: UHC Medicaid |
$5.13
|
| Rate for Payer: UHCCP Medicaid |
$5.13
|
| Rate for Payer: VA VA |
$9.81
|
|
|
HC CHORIONIC VILLUS SAMPLING
|
Facility
|
OP
|
$694.03
|
|
|
Service Code
|
CPT 59015
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$272.75 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Commercial |
$589.93
|
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$580.01
|
| Rate for Payer: BCN Commercial |
$580.01
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cofinity Advantage |
$485.82
|
| Rate for Payer: Cofinity Commercial |
$596.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$624.63
|
| Rate for Payer: Mclaren Medicaid |
$479.98
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.93
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.52
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$589.93
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health SBD |
$437.24
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$451.12
|
| Rate for Payer: UHC Core |
$361.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$272.75
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
HC CHORIONIC VILLUS SAMPLING
|
Facility
|
IP
|
$694.03
|
|
|
Service Code
|
CPT 59015
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$437.24 |
| Max. Negotiated Rate |
$624.63 |
| Rate for Payer: Aetna Commercial |
$589.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.12
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cofinity Advantage |
$485.82
|
| Rate for Payer: Cofinity Commercial |
$596.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.22
|
| Rate for Payer: Healthscope Commercial |
$624.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.52
|
| Rate for Payer: PHP Commercial |
$589.93
|
| Rate for Payer: Priority Health SBD |
$437.24
|
|
|
HC CHROM ANALYSIS METAPHASE <20 AND 20 TO 25
|
Facility
|
OP
|
$258.87
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
31000020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.63 |
| Max. Negotiated Rate |
$232.98 |
| Rate for Payer: Aetna Commercial |
$220.04
|
| Rate for Payer: Aetna Medicare |
$150.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.76
|
| Rate for Payer: BCBS Complete |
$79.42
|
| Rate for Payer: BCBS MAPPO |
$144.61
|
| Rate for Payer: BCBS Trust/PPO |
$154.19
|
| Rate for Payer: BCN Commercial |
$154.19
|
| Rate for Payer: BCN Medicare Advantage |
$144.61
|
| Rate for Payer: Cash Price |
$207.10
|
| Rate for Payer: Cash Price |
$207.10
|
| Rate for Payer: Cofinity Advantage |
$181.21
|
| Rate for Payer: Cofinity Commercial |
$222.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.61
|
| Rate for Payer: Healthscope Commercial |
$232.98
|
| Rate for Payer: Mclaren Medicaid |
$75.63
|
| Rate for Payer: Mclaren Medicare |
$144.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.84
|
| Rate for Payer: Meridian Medicaid |
$151.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.04
|
| Rate for Payer: Nomi Health Commercial |
$216.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.15
|
| Rate for Payer: PACE Medicare |
$137.38
|
| Rate for Payer: PACE SWMI |
$144.61
|
| Rate for Payer: PHP Commercial |
$220.04
|
| Rate for Payer: PHP Medicare Advantage |
$144.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$144.61
|
| Rate for Payer: Priority Health Medicare |
$144.61
|
| Rate for Payer: Priority Health SBD |
$163.09
|
| Rate for Payer: Priority Health Tiered Network |
$115.69
|
| Rate for Payer: Railroad Medicare Medicare |
$144.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.92
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.61
|
| Rate for Payer: UHC Exchange |
$216.92
|
| Rate for Payer: UHC Medicaid |
$75.63
|
| Rate for Payer: UHCCP Medicaid |
$75.63
|
| Rate for Payer: VA VA |
$144.61
|
|
|
HC CHROM ANALYSIS METAPHASE <20 AND 20 TO 25
|
Facility
|
IP
|
$258.87
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
31000020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$163.09 |
| Max. Negotiated Rate |
$232.98 |
| Rate for Payer: Aetna Commercial |
$220.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.27
|
| Rate for Payer: Cash Price |
$207.10
|
| Rate for Payer: Cofinity Advantage |
$181.21
|
| Rate for Payer: Cofinity Commercial |
$222.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.10
|
| Rate for Payer: Healthscope Commercial |
$232.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.15
|
| Rate for Payer: PHP Commercial |
$220.04
|
| Rate for Payer: Priority Health SBD |
$163.09
|
|
