|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
OP
|
$4,122.36
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$294.70 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$3,504.01
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,679.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.80
|
| Rate for Payer: BCN Commercial |
$1,487.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cofinity Commercial |
$3,545.23
|
| Rate for Payer: Cofinity Commercial |
$2,885.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,885.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,297.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,710.12
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,504.01
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,504.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,679.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,597.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.70
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
IP
|
$4,122.36
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,597.09 |
| Max. Negotiated Rate |
$3,710.12 |
| Rate for Payer: Aetna Commercial |
$3,504.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,679.53
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cofinity Commercial |
$2,885.65
|
| Rate for Payer: Cofinity Commercial |
$3,545.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,885.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,297.89
|
| Rate for Payer: Healthscope Commercial |
$3,710.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,504.01
|
| Rate for Payer: PHP Commercial |
$3,504.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,679.53
|
| Rate for Payer: Priority Health SBD |
$2,597.09
|
|
|
HC ENDOVENT
|
Facility
|
OP
|
$4,805.54
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,922.22 |
| Max. Negotiated Rate |
$4,324.99 |
| Rate for Payer: Aetna Commercial |
$4,084.71
|
| Rate for Payer: Aetna Medicare |
$2,402.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,123.60
|
| Rate for Payer: BCBS Complete |
$1,922.22
|
| Rate for Payer: Cash Price |
$3,844.43
|
| Rate for Payer: Cofinity Commercial |
$3,363.88
|
| Rate for Payer: Cofinity Commercial |
$4,132.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,363.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,844.43
|
| Rate for Payer: Healthscope Commercial |
$4,324.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,084.71
|
| Rate for Payer: PHP Commercial |
$4,084.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,123.60
|
| Rate for Payer: Priority Health SBD |
$3,027.49
|
|
|
HC ENDOVENT
|
Facility
|
IP
|
$4,805.54
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,027.49 |
| Max. Negotiated Rate |
$4,324.99 |
| Rate for Payer: Aetna Commercial |
$4,084.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,123.60
|
| Rate for Payer: Cash Price |
$3,844.43
|
| Rate for Payer: Cofinity Commercial |
$3,363.88
|
| Rate for Payer: Cofinity Commercial |
$4,132.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,363.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,844.43
|
| Rate for Payer: Healthscope Commercial |
$4,324.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,084.71
|
| Rate for Payer: PHP Commercial |
$4,084.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,123.60
|
| Rate for Payer: Priority Health SBD |
$3,027.49
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
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 ENGLISH PLANTAIN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
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 ENSITE NAVX KIT
|
Facility
|
OP
|
$4,801.14
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,920.46 |
| Max. Negotiated Rate |
$4,321.03 |
| Rate for Payer: Aetna Commercial |
$4,080.97
|
| Rate for Payer: Aetna Medicare |
$2,400.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,120.74
|
| Rate for Payer: BCBS Complete |
$1,920.46
|
| Rate for Payer: Cash Price |
$3,840.91
|
| Rate for Payer: Cofinity Commercial |
$3,360.80
|
| Rate for Payer: Cofinity Commercial |
$4,128.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,360.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.91
|
| Rate for Payer: Healthscope Commercial |
$4,321.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,080.97
|
| Rate for Payer: PHP Commercial |
$4,080.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,120.74
|
| Rate for Payer: Priority Health SBD |
$3,024.72
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
IP
|
$4,801.14
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,024.72 |
| Max. Negotiated Rate |
$4,321.03 |
| Rate for Payer: Aetna Commercial |
$4,080.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,120.74
|
| Rate for Payer: Cash Price |
$3,840.91
|
| Rate for Payer: Cofinity Commercial |
$3,360.80
|
| Rate for Payer: Cofinity Commercial |
$4,128.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,360.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.91
|
| Rate for Payer: Healthscope Commercial |
$4,321.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,080.97
|
| Rate for Payer: PHP Commercial |
$4,080.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,120.74
|
| Rate for Payer: Priority Health SBD |
$3,024.72
|
|
|
HC ENTEROVIRUS
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
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
|
|
|
HC ENTEROVIRUS
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
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 |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| 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 HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| 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 ENTEROVIRUS BY PCR
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$154.22 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health SBD |
$154.22
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| 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 |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| 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 |
$208.08
|
| 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 |
$208.08
|
| 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 |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| 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 ENTEROVIRUS BY PCR CSF
|
Facility
|
OP
|
$205.73
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$185.16 |
| Rate for Payer: Aetna Commercial |
$174.87
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.72
|
| 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 |
$164.58
|
| Rate for Payer: Cash Price |
$164.58
|
| Rate for Payer: Cofinity Commercial |
$176.93
|
| Rate for Payer: Cofinity Commercial |
$144.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$185.16
|
| 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 |
$174.87
|
| 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 |
$174.87
|
| 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 |
$133.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$129.61
|
| 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 ENTEROVIRUS BY PCR CSF
|
Facility
|
IP
|
$205.73
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$129.61 |
| Max. Negotiated Rate |
$185.16 |
| Rate for Payer: Aetna Commercial |
$174.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.72
|
| Rate for Payer: Cash Price |
$164.58
|
| Rate for Payer: Cofinity Commercial |
$144.01
|
| Rate for Payer: Cofinity Commercial |
$176.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.58
|
| Rate for Payer: Healthscope Commercial |
$185.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.87
|
| Rate for Payer: PHP Commercial |
$174.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.72
|
| Rate for Payer: Priority Health SBD |
$129.61
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health SBD |
$62.27
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| 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 |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| 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 |
$84.01
|
| 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 |
$84.01
|
| 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 |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| 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 ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: PHP Commercial |
$31.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health SBD |
$23.66
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$7.64
|
| Rate for Payer: BCN Commercial |
$7.64
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$33.80
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$12.93
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$31.93
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow Network |
$7.10
|
| Rate for Payer: Priority Health SBD |
$23.66
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.62
|
| Rate for Payer: UHCCP Medicaid |
$4.85
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.44 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.03
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health SBD |
$18.44
|
|
|
HC ENZYME DETECTION
|
Facility
|
OP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna Medicare |
$4.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$4.20
|
| Rate for Payer: BCN Commercial |
$4.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Mclaren Medicaid |
$2.55
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: Nomi Health Commercial |
$7.12
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.75
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health Narrow Network |
$3.80
|
| Rate for Payer: Priority Health SBD |
$18.44
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.67
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$104.10 |
| Max. Negotiated Rate |
$148.72 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.41
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$115.67
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Healthscope Commercial |
$148.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: PHP Commercial |
$140.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: Priority Health SBD |
$104.10
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$104.10 |
| Max. Negotiated Rate |
$2,515.60 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna Medicare |
$832.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.48
|
| Rate for Payer: BCBS Complete |
$450.45
|
| Rate for Payer: BCBS MAPPO |
$800.38
|
| Rate for Payer: BCBS Trust/PPO |
$156.53
|
| Rate for Payer: BCN Commercial |
$156.53
|
| Rate for Payer: BCN Medicare Advantage |
$800.38
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Commercial |
$115.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.38
|
| Rate for Payer: Healthscope Commercial |
$148.72
|
| Rate for Payer: Mclaren Medicaid |
$429.00
|
| Rate for Payer: Mclaren Medicare |
$800.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.40
|
| Rate for Payer: Meridian Medicaid |
$450.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: Nomi Health Commercial |
$2,401.14
|
| Rate for Payer: PACE Medicare |
$760.36
|
| Rate for Payer: PACE SWMI |
$800.38
|
| Rate for Payer: PHP Commercial |
$140.45
|
| Rate for Payer: PHP Medicare Advantage |
$800.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,515.60
|
| Rate for Payer: Priority Health Medicare |
$800.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,012.48
|
| Rate for Payer: Priority Health SBD |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$800.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.38
|
| Rate for Payer: UHC Medicare Advantage |
$800.38
|
| Rate for Payer: UHCCP Medicaid |
$450.61
|
| Rate for Payer: VA VA |
$800.38
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.18 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$29.18
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$6.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.24
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$5.12
|
| Rate for Payer: BCN Commercial |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Mclaren Medicare |
$5.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.08
|
| Rate for Payer: Meridian Medicaid |
$3.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$8.68
|
| Rate for Payer: PACE Medicare |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.79
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health Narrow Network |
$4.63
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.79
|
| Rate for Payer: UHCCP Medicaid |
$3.26
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.52 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: Aetna Medicare |
$15.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.35
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS Trust/PPO |
$17.70
|
| Rate for Payer: BCN Commercial |
$17.70
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health SBD |
$19.73
|
|
