|
HC CORTISOL, SALIVA
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.77 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.44
|
| Rate for Payer: BCN Commercial |
$14.44
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$13.42
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.56
|
| Rate for Payer: UHC Core |
$20.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$20.48
|
| Rate for Payer: UHC Medicare Advantage |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$9.18
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL SERUM
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
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 Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| 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: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
|
|
HC CORTISOL SERUM
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.44
|
| Rate for Payer: BCN Commercial |
$14.44
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$13.42
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.56
|
| Rate for Payer: UHC Core |
$20.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$20.48
|
| Rate for Payer: UHC Medicare Advantage |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$9.18
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL URINE
|
Facility
|
IP
|
$47.86
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.15 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.11
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health SBD |
$30.15
|
|
|
HC CORTISOL URINE
|
Facility
|
OP
|
$47.86
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$57.70 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$14.79
|
| Rate for Payer: BCN Commercial |
$14.79
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Mclaren Medicaid |
$8.96
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$25.06
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.19
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health Narrow Network |
$13.75
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.05
|
| Rate for Payer: UHC Core |
$57.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.71
|
| Rate for Payer: UHC Exchange |
$57.70
|
| Rate for Payer: UHC Medicare Advantage |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$9.41
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
OP
|
$74.89
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$67.40 |
| Rate for Payer: Aetna Commercial |
$63.66
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$14.79
|
| Rate for Payer: BCN Commercial |
$14.79
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$59.91
|
| Rate for Payer: Cash Price |
$59.91
|
| Rate for Payer: Cofinity Commercial |
$52.42
|
| Rate for Payer: Cofinity Commercial |
$64.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$67.40
|
| Rate for Payer: Mclaren Medicaid |
$8.96
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.66
|
| Rate for Payer: Nomi Health Commercial |
$25.06
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$63.66
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.19
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health Narrow Network |
$13.75
|
| Rate for Payer: Priority Health SBD |
$47.18
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.05
|
| Rate for Payer: UHC Core |
$57.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.71
|
| Rate for Payer: UHC Exchange |
$57.70
|
| Rate for Payer: UHC Medicare Advantage |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$9.41
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
IP
|
$74.89
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.18 |
| Max. Negotiated Rate |
$67.40 |
| Rate for Payer: Aetna Commercial |
$63.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.68
|
| Rate for Payer: Cash Price |
$59.91
|
| Rate for Payer: Cofinity Commercial |
$52.42
|
| Rate for Payer: Cofinity Commercial |
$64.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.91
|
| Rate for Payer: Healthscope Commercial |
$67.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.66
|
| Rate for Payer: PHP Commercial |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.68
|
| Rate for Payer: Priority Health SBD |
$47.18
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
IP
|
$27.47
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$24.72 |
| Rate for Payer: Aetna Commercial |
$23.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.86
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$19.23
|
| Rate for Payer: Cofinity Commercial |
$23.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$24.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.35
|
| Rate for Payer: PHP Commercial |
$23.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.86
|
| Rate for Payer: Priority Health SBD |
$17.31
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
OP
|
$27.47
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$36.14 |
| Rate for Payer: Aetna Commercial |
$23.35
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$21.33
|
| Rate for Payer: BCN Commercial |
$21.33
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$19.23
|
| Rate for Payer: Cofinity Commercial |
$23.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$24.72
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.35
|
| Rate for Payer: Nomi Health Commercial |
$36.14
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$23.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$19.27
|
| Rate for Payer: Priority Health SBD |
$17.31
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.91
|
| Rate for Payer: UHC Core |
$16.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$16.50
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$13.56
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC COTTONWOOD IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC COTTONWOOD IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.63
|
| Rate for Payer: BCN Commercial |
$4.63
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
OP
|
$219.30
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$26.56 |
| Max. Negotiated Rate |
$284.86 |
| Rate for Payer: Aetna Commercial |
$186.40
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$41.34
|
| Rate for Payer: BCN Commercial |
$41.34
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$175.44
|
| Rate for Payer: Cash Price |
$175.44
|
| Rate for Payer: Cofinity Commercial |
$188.60
|
| Rate for Payer: Cofinity Commercial |
$153.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$197.37
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.40
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$186.40
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.86
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$227.89
|
| Rate for Payer: Priority Health SBD |
$138.16
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$51.02
|
| Rate for Payer: VA VA |
$90.63
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
IP
|
$219.30
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$138.16 |
| Max. Negotiated Rate |
$197.37 |
| Rate for Payer: Aetna Commercial |
$186.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.54
|
| Rate for Payer: Cash Price |
$175.44
|
| Rate for Payer: Cofinity Commercial |
$153.51
|
| Rate for Payer: Cofinity Commercial |
$188.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.44
|
| Rate for Payer: Healthscope Commercial |
$197.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.40
|
| Rate for Payer: PHP Commercial |
$186.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.54
|
| Rate for Payer: Priority Health SBD |
$138.16
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health SBD |
$48.20
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health SBD |
$48.20
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,524.94
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,609.98 |
| Max. Negotiated Rate |
$5,872.45 |
| Rate for Payer: Aetna Commercial |
$5,546.20
|
| Rate for Payer: Aetna Medicare |
$3,262.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,241.21
|
| Rate for Payer: BCBS Complete |
$2,609.98
|
| Rate for Payer: Cash Price |
$5,219.95
|
| Rate for Payer: Cofinity Commercial |
$4,567.46
|
| Rate for Payer: Cofinity Commercial |
$5,611.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,567.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,219.95
|
| Rate for Payer: Healthscope Commercial |
$5,872.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.20
|
| Rate for Payer: PHP Commercial |
$5,546.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.21
|
| Rate for Payer: Priority Health SBD |
$4,110.71
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
IP
|
$6,524.94
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,110.71 |
| Max. Negotiated Rate |
$5,872.45 |
| Rate for Payer: Aetna Commercial |
$5,546.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,241.21
|
| Rate for Payer: Cash Price |
$5,219.95
|
| Rate for Payer: Cofinity Commercial |
$4,567.46
|
| Rate for Payer: Cofinity Commercial |
$5,611.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,567.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,219.95
|
| Rate for Payer: Healthscope Commercial |
$5,872.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.20
|
| Rate for Payer: PHP Commercial |
$5,546.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.21
|
| Rate for Payer: Priority Health SBD |
$4,110.71
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$126.39 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$63.68
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$126.39
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.13
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health Narrow Network |
$33.70
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.13
|
| Rate for Payer: UHC Medicare Advantage |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$23.72
|
| Rate for Payer: VA VA |
$42.13
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$63.68 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health SBD |
$44.57
|
|
|
HC COVID 19 PCR
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$82.62
|
| Rate for Payer: BCN Commercial |
$82.62
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$87.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$153.93
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.31
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$41.05
|
| Rate for Payer: Priority Health SBD |
$78.66
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.57
|
| Rate for Payer: UHC Core |
$61.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$61.57
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$28.89
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC COVID 19 PCR
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.66 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.15
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$87.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health SBD |
$78.66
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
OP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna Commercial |
$128.23
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$82.62
|
| Rate for Payer: BCN Commercial |
$82.62
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$129.74
|
| Rate for Payer: Cofinity Commercial |
$105.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$135.77
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$153.93
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.31
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$41.05
|
| Rate for Payer: Priority Health SBD |
$95.04
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$28.89
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
IP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$95.04 |
| Max. Negotiated Rate |
$135.77 |
| Rate for Payer: Aetna Commercial |
$128.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.06
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$129.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health SBD |
$95.04
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$160.59 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.68
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.68
|
| Rate for Payer: Priority Health SBD |
$160.59
|
|
