|
HC C PEPTIDE LEVEL
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.83
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Advantage |
$26.74
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health SBD |
$24.07
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.83
|
| 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 |
$30.56
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Advantage |
$26.74
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| 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 |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$32.47
|
| 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 |
$24.07
|
| 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 CPK
|
Facility
|
IP
|
$54.33
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.23 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$46.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.31
|
| Rate for Payer: Cash Price |
$43.46
|
| Rate for Payer: Cofinity Advantage |
$38.03
|
| Rate for Payer: Cofinity Commercial |
$46.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.46
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.75
|
| Rate for Payer: PHP Commercial |
$46.18
|
| Rate for Payer: Priority Health SBD |
$34.23
|
|
|
HC CPK
|
Facility
|
OP
|
$54.33
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$46.18
|
| Rate for Payer: Aetna Medicare |
$6.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.14
|
| Rate for Payer: BCBS Complete |
$3.58
|
| Rate for Payer: BCBS MAPPO |
$6.51
|
| Rate for Payer: BCN Medicare Advantage |
$6.51
|
| Rate for Payer: Cash Price |
$43.46
|
| Rate for Payer: Cash Price |
$43.46
|
| Rate for Payer: Cofinity Advantage |
$38.03
|
| Rate for Payer: Cofinity Commercial |
$46.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.51
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Mclaren Medicaid |
$3.40
|
| Rate for Payer: Mclaren Medicare |
$6.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.84
|
| Rate for Payer: Meridian Medicaid |
$6.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.18
|
| Rate for Payer: Nomi Health Commercial |
$9.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.75
|
| Rate for Payer: PACE Medicare |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.51
|
| Rate for Payer: PHP Commercial |
$46.18
|
| Rate for Payer: PHP Medicare Advantage |
$6.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.51
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health SBD |
$34.23
|
| Rate for Payer: Priority Health Tiered Network |
$5.21
|
| Rate for Payer: Railroad Medicare Medicare |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.77
|
| Rate for Payer: UHC Core |
$9.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.51
|
| Rate for Payer: UHC Exchange |
$9.77
|
| Rate for Payer: UHC Medicaid |
$3.40
|
| Rate for Payer: UHCCP Medicaid |
$3.40
|
| Rate for Payer: VA VA |
$6.51
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
IP
|
$420.54
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$264.94 |
| Max. Negotiated Rate |
$378.49 |
| Rate for Payer: Aetna Commercial |
$357.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.35
|
| Rate for Payer: Cash Price |
$336.43
|
| Rate for Payer: Cofinity Advantage |
$294.38
|
| Rate for Payer: Cofinity Commercial |
$361.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.43
|
| Rate for Payer: Healthscope Commercial |
$378.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.40
|
| Rate for Payer: PHP Commercial |
$357.46
|
| Rate for Payer: Priority Health SBD |
$264.94
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
OP
|
$420.54
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$92.50 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna Commercial |
$357.46
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCN Medicare Advantage |
$176.86
|
| Rate for Payer: Cash Price |
$336.43
|
| Rate for Payer: Cash Price |
$336.43
|
| Rate for Payer: Cofinity Advantage |
$294.38
|
| Rate for Payer: Cofinity Commercial |
$361.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$378.49
|
| Rate for Payer: Mclaren Medicaid |
$92.50
|
| Rate for Payer: Mclaren Medicare |
$176.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.70
|
| Rate for Payer: Meridian Medicaid |
$185.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.46
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.40
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$357.46
|
| Rate for Payer: PHP Medicare Advantage |
$176.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$571.94
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health SBD |
$264.94
|
| Rate for Payer: Priority Health Tiered Network |
$457.55
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.35
|
| Rate for Payer: UHC Core |
$219.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$176.86
|
| Rate for Payer: UHC Exchange |
$165.27
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: VA VA |
$176.86
|
|
|
HC CPR
|
Facility
|
OP
|
$999.61
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$899.65 |
| Rate for Payer: Aetna Commercial |
$849.67
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.75
|
| 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 |
$230.91
|
| Rate for Payer: BCN Commercial |
$230.91
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$799.69
|
| Rate for Payer: Cash Price |
$799.69
|
| Rate for Payer: Cash Price |
$799.69
|
| Rate for Payer: Cofinity Advantage |
$699.73
|
| Rate for Payer: Cofinity Commercial |
$859.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$899.65
|
| 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 |
$849.67
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.71
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$849.67
|
| 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 |
$629.75
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$144.00
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC CPR
|
Facility
|
IP
|
$999.61
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$629.75 |
| Max. Negotiated Rate |
$899.65 |
| Rate for Payer: Aetna Commercial |
$849.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.75
|
| Rate for Payer: Cash Price |
$799.69
|
| Rate for Payer: Cofinity Advantage |
$699.73
|
| Rate for Payer: Cofinity Commercial |
$859.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.69
|
| Rate for Payer: Healthscope Commercial |
$899.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.71
|
| Rate for Payer: PHP Commercial |
$849.67
|
| Rate for Payer: Priority Health SBD |
$629.75
|
|
|
HC CRAB IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CRAB IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC CRE
|
Facility
|
IP
|
$1,482.28
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$933.84 |
| Max. Negotiated Rate |
$1,334.05 |
| Rate for Payer: Aetna Commercial |
$1,259.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.48
|
| Rate for Payer: Cash Price |
$1,185.82
|
| Rate for Payer: Cofinity Advantage |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,274.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.82
|
| Rate for Payer: Healthscope Commercial |
$1,334.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.71
|
| Rate for Payer: PHP Commercial |
$1,259.94
|
| Rate for Payer: Priority Health SBD |
$933.84
|
|
|
HC CRE
|
Facility
|
OP
|
$1,482.28
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,334.05 |
| Rate for Payer: Aetna Commercial |
$1,259.94
|
| Rate for Payer: Aetna Medicare |
$741.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.48
|
| Rate for Payer: BCBS Complete |
$592.91
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,185.82
|
| Rate for Payer: Cash Price |
$1,185.82
|
| Rate for Payer: Cofinity Advantage |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,274.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.82
|
| Rate for Payer: Healthscope Commercial |
$1,334.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,185.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.71
|
| Rate for Payer: PHP Commercial |
$1,259.94
|
| Rate for Payer: Priority Health SBD |
$933.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.48
|
| Rate for Payer: UHC Core |
$772.27
|
| Rate for Payer: UHC Exchange |
$582.54
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
IP
|
$62.84
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.59 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Advantage |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: Priority Health SBD |
$39.59
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
OP
|
$62.84
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$5.53
|
| Rate for Payer: BCN Commercial |
$5.53
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Advantage |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Mclaren Medicaid |
$2.71
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$39.59
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
IP
|
$5,261.47
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,314.73 |
| Max. Negotiated Rate |
$4,735.32 |
| Rate for Payer: Aetna Commercial |
$4,472.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,419.96
|
| Rate for Payer: Cash Price |
$4,209.18
|
| Rate for Payer: Cofinity Advantage |
$3,683.03
|
| Rate for Payer: Cofinity Commercial |
$4,524.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,209.18
|
| Rate for Payer: Healthscope Commercial |
$4,735.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,472.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,946.10
|
| Rate for Payer: PHP Commercial |
$4,472.25
|
| Rate for Payer: Priority Health SBD |
$3,314.73
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
OP
|
$5,261.47
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,742.58 |
| Max. Negotiated Rate |
$12,668.06 |
| Rate for Payer: Aetna Commercial |
$4,472.25
|
| Rate for Payer: Aetna Medicare |
$4,073.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,419.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,896.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,896.57
|
| Rate for Payer: BCBS Complete |
$2,151.36
|
| Rate for Payer: BCBS MAPPO |
$3,917.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,742.58
|
| Rate for Payer: BCN Commercial |
$1,742.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,917.26
|
| Rate for Payer: Cash Price |
$4,209.18
|
| Rate for Payer: Cash Price |
$4,209.18
|
| Rate for Payer: Cash Price |
$4,209.18
|
| Rate for Payer: Cofinity Advantage |
$3,683.03
|
| Rate for Payer: Cofinity Commercial |
$4,524.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,209.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,917.26
|
| Rate for Payer: Healthscope Commercial |
$4,735.32
|
| Rate for Payer: Mclaren Medicaid |
$2,048.73
|
| Rate for Payer: Mclaren Medicare |
$3,917.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,113.12
|
| Rate for Payer: Meridian Medicaid |
$4,113.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,504.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,308.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,472.25
|
| Rate for Payer: Nomi Health Commercial |
$11,751.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,946.10
|
| Rate for Payer: PACE Medicare |
$3,721.40
|
| Rate for Payer: PACE SWMI |
$3,917.26
|
| Rate for Payer: PHP Commercial |
$4,472.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,917.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,048.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,668.06
|
| Rate for Payer: Priority Health Medicare |
$3,917.26
|
| Rate for Payer: Priority Health SBD |
$3,314.73
|
| Rate for Payer: Priority Health Tiered Network |
$10,134.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,917.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,419.96
|
| Rate for Payer: UHC Core |
$2,741.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,917.26
|
| Rate for Payer: UHC Exchange |
$2,067.76
|
| Rate for Payer: UHC Medicaid |
$2,048.73
|
| Rate for Payer: UHCCP Medicaid |
$2,048.73
|
| Rate for Payer: VA VA |
$3,917.26
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$9.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.82
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$9.46
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: BCN Commercial |
$10.09
|
| Rate for Payer: BCN Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Mclaren Medicaid |
$4.95
|
| Rate for Payer: Mclaren Medicare |
$9.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.93
|
| Rate for Payer: Meridian Medicaid |
$9.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$14.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$8.99
|
| Rate for Payer: PACE SWMI |
$9.46
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$9.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.46
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Priority Health Tiered Network |
$7.57
|
| Rate for Payer: Railroad Medicare Medicare |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$14.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.46
|
| Rate for Payer: UHC Exchange |
$14.19
|
| Rate for Payer: UHC Medicaid |
$4.95
|
| Rate for Payer: UHCCP Medicaid |
$4.95
|
| Rate for Payer: VA VA |
$9.46
|
|
|
HC CREATININE SERUM
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
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 CREATININE SERUM
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: BCBS Complete |
$2.81
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| 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 |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$2.68
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$5.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.12
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$4.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.68
|
| Rate for Payer: UHC Core |
$7.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.68
|
| Rate for Payer: UHC Medicaid |
$2.68
|
| Rate for Payer: UHCCP Medicaid |
$2.68
|
| Rate for Payer: VA VA |
$5.12
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
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 CREATININE URINE/OTHER SOURCE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$5.53
|
| Rate for Payer: BCN Commercial |
$5.53
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| 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 |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Mclaren Medicaid |
$2.71
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: BCBS Complete |
$2.81
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Advantage |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.68
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$5.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.61
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.12
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Priority Health Tiered Network |
$4.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.68
|
| Rate for Payer: UHC Core |
$7.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.68
|
| Rate for Payer: UHC Medicaid |
$2.68
|
| Rate for Payer: UHCCP Medicaid |
$2.68
|
| Rate for Payer: VA VA |
$5.12
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Advantage |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.61
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health SBD |
$13.11
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
OP
|
$40.79
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$36.71 |
| Rate for Payer: Aetna Commercial |
$34.67
|
| Rate for Payer: Aetna Medicare |
$20.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.51
|
| Rate for Payer: BCBS Complete |
$16.32
|
| Rate for Payer: Cash Price |
$32.63
|
| Rate for Payer: Cofinity Advantage |
$28.55
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.63
|
| Rate for Payer: Healthscope Commercial |
$36.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.59
|
| Rate for Payer: PHP Commercial |
$34.67
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.51
|
| Rate for Payer: UHC Core |
$21.25
|
| Rate for Payer: UHC Exchange |
$16.03
|
|
