|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$42.32
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$38.09 |
| Rate for Payer: Aetna Commercial |
$35.97
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: BCBS Complete |
$12.98
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$25.20
|
| Rate for Payer: BCN Commercial |
$25.20
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cofinity Advantage |
$29.62
|
| Rate for Payer: Cofinity Commercial |
$36.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$38.09
|
| Rate for Payer: Mclaren Medicaid |
$12.36
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.97
|
| Rate for Payer: Nomi Health Commercial |
$35.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.74
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$35.97
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.64
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health SBD |
$26.66
|
| Rate for Payer: Priority Health Tiered Network |
$18.91
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.46
|
| Rate for Payer: UHC Core |
$35.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.64
|
| Rate for Payer: UHC Exchange |
$35.46
|
| Rate for Payer: UHC Medicaid |
$12.36
|
| Rate for Payer: UHCCP Medicaid |
$12.36
|
| Rate for Payer: VA VA |
$23.64
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$21.67
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Advantage |
$15.17
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Mclaren Medicaid |
$6.33
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Meridian Medicaid |
$12.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: Nomi Health Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.25
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.11
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health SBD |
$13.65
|
| Rate for Payer: Priority Health Tiered Network |
$9.69
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.17
|
| Rate for Payer: UHC Core |
$18.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.11
|
| Rate for Payer: UHC Exchange |
$18.17
|
| Rate for Payer: UHC Medicaid |
$6.33
|
| Rate for Payer: UHCCP Medicaid |
$6.33
|
| Rate for Payer: VA VA |
$12.11
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$21.67
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.09
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Advantage |
$15.17
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.25
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: Priority Health SBD |
$13.65
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.39 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.07
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Advantage |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: Priority Health SBD |
$21.39
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$20.23
|
| Rate for Payer: BCN Commercial |
$20.23
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Advantage |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.97
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$21.39
|
| Rate for Payer: Priority Health Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Core |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$28.51
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$25.66 |
| Rate for Payer: Aetna Commercial |
$24.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.53
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cofinity Advantage |
$19.96
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.81
|
| Rate for Payer: Healthscope Commercial |
$25.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.38
|
| Rate for Payer: PHP Commercial |
$24.23
|
| Rate for Payer: Priority Health SBD |
$17.96
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$28.51
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$25.66 |
| Rate for Payer: Aetna Commercial |
$24.23
|
| Rate for Payer: Aetna Medicare |
$4.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.25
|
| Rate for Payer: BCBS Complete |
$2.31
|
| Rate for Payer: BCBS MAPPO |
$4.20
|
| Rate for Payer: BCBS Trust/PPO |
$4.48
|
| Rate for Payer: BCN Commercial |
$4.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.20
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cofinity Advantage |
$19.96
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$25.66
|
| Rate for Payer: Mclaren Medicaid |
$2.20
|
| Rate for Payer: Mclaren Medicare |
$4.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.41
|
| Rate for Payer: Meridian Medicaid |
$4.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$6.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.38
|
| Rate for Payer: PACE Medicare |
$3.99
|
| Rate for Payer: PACE SWMI |
$4.20
|
| Rate for Payer: PHP Commercial |
$24.23
|
| Rate for Payer: PHP Medicare Advantage |
$4.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.20
|
| Rate for Payer: Priority Health Medicare |
$4.20
|
| Rate for Payer: Priority Health SBD |
$17.96
|
| Rate for Payer: Priority Health Tiered Network |
$3.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.30
|
| Rate for Payer: UHC Core |
$6.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.20
|
| Rate for Payer: UHC Exchange |
$6.30
|
| Rate for Payer: UHC Medicaid |
$2.20
|
| Rate for Payer: UHCCP Medicaid |
$2.20
|
| Rate for Payer: VA VA |
$4.20
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$8.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.82
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$7.86
|
| Rate for Payer: BCBS Trust/PPO |
$8.39
|
| Rate for Payer: BCN Commercial |
$8.39
|
| Rate for Payer: BCN Medicare Advantage |
$7.86
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.86
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$4.11
|
| Rate for Payer: Mclaren Medicare |
$7.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.25
|
| Rate for Payer: Meridian Medicaid |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$11.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$7.47
|
| Rate for Payer: PACE SWMI |
$7.86
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$7.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.86
|
| Rate for Payer: Priority Health Medicare |
$7.86
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$6.29
|
| Rate for Payer: Railroad Medicare Medicare |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.79
|
| Rate for Payer: UHC Core |
$11.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.86
|
| Rate for Payer: UHC Exchange |
$11.79
|
| Rate for Payer: UHC Medicaid |
$4.11
|
| Rate for Payer: UHCCP Medicaid |
$4.11
|
| Rate for Payer: VA VA |
$7.86
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.53 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.77
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Advantage |
$78.36
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: Priority Health SBD |
$70.53
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.25
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$17.97
|
| Rate for Payer: BCN Commercial |
$17.97
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Advantage |
$78.36
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Mclaren Medicaid |
$8.81
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$17.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$25.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$70.53
|
| Rate for Payer: Priority Health Tiered Network |
$13.48
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.28
|
| Rate for Payer: UHC Core |
$25.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.85
|
| Rate for Payer: UHC Exchange |
$25.28
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
OP
|
$159.18
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.23 |
| Max. Negotiated Rate |
$143.26 |
| Rate for Payer: Aetna Commercial |
$135.30
|
| Rate for Payer: Aetna Medicare |
$70.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.20
|
| Rate for Payer: BCBS Complete |
$36.99
|
| Rate for Payer: BCBS MAPPO |
$67.36
|
| Rate for Payer: BCBS Trust/PPO |
$71.82
|
| Rate for Payer: BCN Commercial |
$71.82
|
| Rate for Payer: BCN Medicare Advantage |
$67.36
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cofinity Advantage |
$111.43
|
| Rate for Payer: Cofinity Commercial |
$136.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.36
|
| Rate for Payer: Healthscope Commercial |
$143.26
|
| Rate for Payer: Mclaren Medicaid |
$35.23
|
| Rate for Payer: Mclaren Medicare |
$67.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.73
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.30
|
| Rate for Payer: Nomi Health Commercial |
$101.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.39
|
| Rate for Payer: PACE Medicare |
$63.99
|
| Rate for Payer: PACE SWMI |
$67.36
|
| Rate for Payer: PHP Commercial |
$135.30
|
| Rate for Payer: PHP Medicare Advantage |
$67.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.36
|
| Rate for Payer: Priority Health Medicare |
$67.36
|
| Rate for Payer: Priority Health SBD |
$100.28
|
| Rate for Payer: Priority Health Tiered Network |
$53.89
|
| Rate for Payer: Railroad Medicare Medicare |
$67.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.04
|
| Rate for Payer: UHC Core |
$101.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.36
|
| Rate for Payer: UHC Exchange |
$101.04
|
| Rate for Payer: UHC Medicaid |
$35.23
|
| Rate for Payer: UHCCP Medicaid |
$35.23
|
| Rate for Payer: VA VA |
$67.36
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
IP
|
$159.18
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$100.28 |
| Max. Negotiated Rate |
$143.26 |
| Rate for Payer: Aetna Commercial |
$135.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.47
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cofinity Advantage |
$111.43
|
| Rate for Payer: Cofinity Commercial |
$136.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.34
|
| Rate for Payer: Healthscope Commercial |
$143.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.39
|
| Rate for Payer: PHP Commercial |
$135.30
|
| Rate for Payer: Priority Health SBD |
$100.28
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC HEMATOCRIT
|
Facility
|
OP
|
$24.35
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$21.91 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.96
|
| Rate for Payer: BCBS Complete |
$1.30
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCBS Trust/PPO |
$2.53
|
| Rate for Payer: BCN Commercial |
$2.53
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cofinity Advantage |
$17.05
|
| Rate for Payer: Cofinity Commercial |
$20.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Healthscope Commercial |
$21.91
|
| Rate for Payer: Mclaren Medicaid |
$1.24
|
| Rate for Payer: Mclaren Medicare |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Meridian Medicaid |
$2.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.70
|
| Rate for Payer: Nomi Health Commercial |
$3.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.26
|
| Rate for Payer: PACE Medicare |
$2.25
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Commercial |
$20.70
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.37
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: Priority Health SBD |
$15.34
|
| Rate for Payer: Priority Health Tiered Network |
$1.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.56
|
| Rate for Payer: UHC Core |
$3.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.37
|
| Rate for Payer: UHC Exchange |
$3.56
|
| Rate for Payer: UHC Medicaid |
$1.24
|
| Rate for Payer: UHCCP Medicaid |
$1.24
|
| Rate for Payer: VA VA |
$2.37
|
|
|
HC HEMATOCRIT
|
Facility
|
IP
|
$24.35
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$21.91 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.83
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cofinity Advantage |
$17.05
|
| Rate for Payer: Cofinity Commercial |
$20.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.48
|
| Rate for Payer: Healthscope Commercial |
$21.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.26
|
| Rate for Payer: PHP Commercial |
$20.70
|
| Rate for Payer: Priority Health SBD |
$15.34
|
|
|
HC HEMOCHROMATOSIS GENE ANALYSIS
|
Facility
|
IP
|
$270.61
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
31000100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$170.48 |
| Max. Negotiated Rate |
$243.55 |
| Rate for Payer: Aetna Commercial |
$230.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.90
|
| Rate for Payer: Cash Price |
$216.49
|
| Rate for Payer: Cofinity Advantage |
$189.43
|
| Rate for Payer: Cofinity Commercial |
$232.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.49
|
| Rate for Payer: Healthscope Commercial |
$243.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.96
|
| Rate for Payer: PHP Commercial |
$230.02
|
| Rate for Payer: Priority Health SBD |
$170.48
|
|
|
HC HEMOCHROMATOSIS GENE ANALYSIS
|
Facility
|
OP
|
$270.61
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
31000100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.18 |
| Max. Negotiated Rate |
$243.55 |
| Rate for Payer: Aetna Commercial |
$230.02
|
| Rate for Payer: Aetna Medicare |
$67.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.70
|
| Rate for Payer: BCBS Complete |
$35.90
|
| Rate for Payer: BCBS MAPPO |
$65.36
|
| Rate for Payer: BCBS Trust/PPO |
$69.69
|
| Rate for Payer: BCN Commercial |
$69.69
|
| Rate for Payer: BCN Medicare Advantage |
$65.36
|
| Rate for Payer: Cash Price |
$216.49
|
| Rate for Payer: Cash Price |
$216.49
|
| Rate for Payer: Cofinity Advantage |
$189.43
|
| Rate for Payer: Cofinity Commercial |
$232.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.36
|
| Rate for Payer: Healthscope Commercial |
$243.55
|
| Rate for Payer: Mclaren Medicaid |
$34.18
|
| Rate for Payer: Mclaren Medicare |
$65.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.63
|
| Rate for Payer: Meridian Medicaid |
$68.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.02
|
| Rate for Payer: Nomi Health Commercial |
$196.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.96
|
| Rate for Payer: PACE Medicare |
$62.09
|
| Rate for Payer: PACE SWMI |
$65.36
|
| Rate for Payer: PHP Commercial |
$230.02
|
| Rate for Payer: PHP Medicare Advantage |
$65.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.36
|
| Rate for Payer: Priority Health Medicare |
$65.36
|
| Rate for Payer: Priority Health SBD |
$170.48
|
| Rate for Payer: Priority Health Tiered Network |
$52.29
|
| Rate for Payer: Railroad Medicare Medicare |
$65.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.04
|
| Rate for Payer: UHC Core |
$98.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.36
|
| Rate for Payer: UHC Exchange |
$98.04
|
| Rate for Payer: UHC Medicaid |
$34.18
|
| Rate for Payer: UHCCP Medicaid |
$34.18
|
| Rate for Payer: VA VA |
$65.36
|
|
|
HC HEMO CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500002
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$189.00 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Advantage |
$210.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health SBD |
$189.00
|
|
|
HC HEMO CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500002
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$117.90 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$150.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.00
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Trust/PPO |
$211.09
|
| Rate for Payer: BCN Commercial |
$211.09
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Advantage |
$210.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health SBD |
$189.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.00
|
| Rate for Payer: UHC Core |
$156.30
|
| Rate for Payer: UHC Exchange |
$117.90
|
|
|
HC HEMO CMS F/U
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500003
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$119.83 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.25
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$119.83
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$119.83
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Advantage |
$87.50
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health SBD |
$78.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.25
|
| Rate for Payer: UHC Core |
$65.12
|
| Rate for Payer: UHC Exchange |
$49.12
|
|
|
HC HEMO CMS F/U
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500003
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Advantage |
$87.50
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health SBD |
$78.75
|
|
|
HC HEMO CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$225.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.50
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS Trust/PPO |
$211.09
|
| Rate for Payer: BCN Commercial |
$211.09
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Advantage |
$315.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$360.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health SBD |
$283.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.50
|
| Rate for Payer: UHC Core |
$234.45
|
| Rate for Payer: UHC Exchange |
$176.85
|
|
|
HC HEMO CMS INITIAL COMP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.50
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Advantage |
$315.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health SBD |
$283.50
|
|
