|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$19.77
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$23.56 |
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$5.72
|
| Rate for Payer: BCN Commercial |
$5.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$13.84
|
| Rate for Payer: Cofinity Commercial |
$17.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$17.79
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$9.70
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.65
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$5.32
|
| Rate for Payer: Priority Health SBD |
$12.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.76
|
| Rate for Payer: UHC Core |
$23.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$23.56
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.58 |
| Max. Negotiated Rate |
$20.83 |
| Rate for Payer: Aetna Commercial |
$19.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.04
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$16.20
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Healthscope Commercial |
$20.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: PHP Commercial |
$19.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health SBD |
$14.58
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$21.21 |
| Rate for Payer: Aetna Commercial |
$19.67
|
| Rate for Payer: Aetna Medicare |
$14.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.68
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: BCBS MAPPO |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.52
|
| Rate for Payer: BCN Commercial |
$12.52
|
| Rate for Payer: BCN Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$16.20
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$20.83
|
| Rate for Payer: Mclaren Medicaid |
$7.58
|
| Rate for Payer: Mclaren Medicare |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.85
|
| Rate for Payer: Meridian Medicaid |
$7.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: Nomi Health Commercial |
$21.21
|
| Rate for Payer: PACE Medicare |
$13.43
|
| Rate for Payer: PACE SWMI |
$14.14
|
| Rate for Payer: PHP Commercial |
$19.67
|
| Rate for Payer: PHP Medicare Advantage |
$14.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.14
|
| Rate for Payer: Priority Health Medicare |
$14.14
|
| Rate for Payer: Priority Health Narrow Network |
$11.31
|
| Rate for Payer: Priority Health SBD |
$14.58
|
| Rate for Payer: Railroad Medicare Medicare |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.97
|
| Rate for Payer: UHC Core |
$6.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.14
|
| Rate for Payer: UHC Exchange |
$6.40
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: UHCCP Medicaid |
$7.96
|
| Rate for Payer: VA VA |
$14.14
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.63 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health SBD |
$27.63
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$5.72
|
| Rate for Payer: BCN Commercial |
$5.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$9.70
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.65
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$5.32
|
| Rate for Payer: Priority Health SBD |
$27.63
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.76
|
| Rate for Payer: UHC Core |
$23.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$23.56
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$195.76 |
| Rate for Payer: Aetna Commercial |
$121.69
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$123.12
|
| Rate for Payer: Cofinity Commercial |
$100.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$128.84
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$121.69
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$90.19
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$105.94
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$90.19 |
| Max. Negotiated Rate |
$128.84 |
| Rate for Payer: Aetna Commercial |
$121.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.05
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$100.21
|
| Rate for Payer: Cofinity Commercial |
$123.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Healthscope Commercial |
$128.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: PHP Commercial |
$121.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: Priority Health SBD |
$90.19
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$306.70 |
| Rate for Payer: Aetna Commercial |
$289.66
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$293.07
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$306.70
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$289.66
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$214.69
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$252.18
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$214.69 |
| Max. Negotiated Rate |
$306.70 |
| Rate for Payer: Aetna Commercial |
$289.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.51
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Cofinity Commercial |
$293.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Healthscope Commercial |
$306.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: PHP Commercial |
$289.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: Priority Health SBD |
$214.69
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$156.74
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$184.11
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$156.74 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health SBD |
$156.74
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$156.74
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$184.11
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$156.74 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health SBD |
$156.74
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$156.74
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$184.11
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$156.74 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health SBD |
$156.74
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$156.74 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health SBD |
$156.74
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$156.74
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$184.11
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.99
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$186.84
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.76
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$156.61
|
| Rate for Payer: Priority Health SBD |
$156.74
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$184.11
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$35.06
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$156.74 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.72
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$174.16
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health SBD |
$156.74
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$553.35
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.86 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$470.35
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$62.86
|
| Rate for Payer: BCN Commercial |
$62.86
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cofinity Commercial |
$475.88
|
| Rate for Payer: Cofinity Commercial |
$387.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$387.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$498.02
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.35
|
| Rate for Payer: Nomi Health Commercial |
$408.83
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$470.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$348.61
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.64
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$109.60
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$553.35
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$498.02 |
| Rate for Payer: Aetna Commercial |
$470.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.68
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cofinity Commercial |
$387.34
|
| Rate for Payer: Cofinity Commercial |
$475.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$387.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.68
|
| Rate for Payer: Healthscope Commercial |
$498.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.35
|
| Rate for Payer: PHP Commercial |
$470.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.68
|
| Rate for Payer: Priority Health SBD |
$348.61
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health SBD |
$29.50
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$14.22
|
| Rate for Payer: BCN Commercial |
$14.22
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$24.10
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$9.05
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.07
|
| Rate for Payer: BCN Commercial |
$31.07
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
|
