|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$14.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: BCBS Complete |
$7.57
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$14.70
|
| Rate for Payer: BCN Commercial |
$14.70
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Advantage |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Mclaren Medicare |
$13.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: Meridian Medicaid |
$14.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$20.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: PACE Medicare |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.79
|
| Rate for Payer: Priority Health Medicare |
$13.79
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Priority Health Tiered Network |
$11.03
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.69
|
| Rate for Payer: UHC Core |
$20.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.79
|
| Rate for Payer: UHC Exchange |
$20.69
|
| Rate for Payer: UHC Medicaid |
$7.21
|
| Rate for Payer: UHCCP Medicaid |
$7.21
|
| Rate for Payer: VA VA |
$13.79
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
OP
|
$139.41
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$14.13
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Nomi Health Commercial |
$19.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health SBD |
$87.83
|
| Rate for Payer: Priority Health Tiered Network |
$10.60
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.88
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.25
|
| Rate for Payer: UHC Exchange |
$19.88
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
IP
|
$139.41
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.83 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: Priority Health SBD |
$87.83
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
IP
|
$139.41
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.83 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: Priority Health SBD |
$87.83
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
OP
|
$139.41
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$14.13
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Nomi Health Commercial |
$19.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health SBD |
$87.83
|
| Rate for Payer: Priority Health Tiered Network |
$10.60
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.88
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.25
|
| Rate for Payer: UHC Exchange |
$19.88
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
OP
|
$139.41
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$14.13
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Nomi Health Commercial |
$19.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health SBD |
$87.83
|
| Rate for Payer: Priority Health Tiered Network |
$10.60
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.88
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.25
|
| Rate for Payer: UHC Exchange |
$19.88
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
IP
|
$139.41
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.83 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: Priority Health SBD |
$87.83
|
|
|
HC HIT ASSAY
|
Facility
|
OP
|
$180.41
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$162.37 |
| Rate for Payer: Aetna Commercial |
$153.35
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$19.59
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cofinity Advantage |
$126.29
|
| Rate for Payer: Cofinity Commercial |
$155.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.35
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.31
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$153.35
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$113.66
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC HIT ASSAY
|
Facility
|
IP
|
$180.41
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$113.66 |
| Max. Negotiated Rate |
$162.37 |
| Rate for Payer: Aetna Commercial |
$153.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.27
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cofinity Advantage |
$126.29
|
| Rate for Payer: Cofinity Commercial |
$155.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.33
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.31
|
| Rate for Payer: PHP Commercial |
$153.35
|
| Rate for Payer: Priority Health SBD |
$113.66
|
|
|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$25.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.10
|
| Rate for Payer: BCBS Complete |
$13.22
|
| Rate for Payer: BCBS MAPPO |
$24.08
|
| Rate for Payer: BCBS Trust/PPO |
$25.67
|
| Rate for Payer: BCN Commercial |
$25.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.08
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Advantage |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.08
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Mclaren Medicaid |
$12.59
|
| Rate for Payer: Mclaren Medicare |
$24.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.28
|
| Rate for Payer: Meridian Medicaid |
$25.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$36.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Medicare |
$22.88
|
| Rate for Payer: PACE SWMI |
$24.08
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$24.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.08
|
| Rate for Payer: Priority Health Medicare |
$24.08
|
| Rate for Payer: Priority Health SBD |
$32.09
|
| Rate for Payer: Priority Health Tiered Network |
$19.26
|
| Rate for Payer: Railroad Medicare Medicare |
$24.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.12
|
| Rate for Payer: UHC Core |
$36.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.08
|
| Rate for Payer: UHC Exchange |
$36.12
|
| Rate for Payer: UHC Medicaid |
$12.59
|
| Rate for Payer: UHCCP Medicaid |
$12.59
|
| Rate for Payer: VA VA |
$24.08
|
|
|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.09 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Advantage |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health SBD |
$32.09
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.11
|
| Rate for Payer: BCBS Complete |
$4.88
|
| Rate for Payer: BCBS MAPPO |
$8.89
|
| Rate for Payer: BCBS Trust/PPO |
$9.48
|
| Rate for Payer: BCN Commercial |
$9.48
|
| Rate for Payer: BCN Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$4.65
|
| Rate for Payer: Mclaren Medicare |
$8.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.33
|
| Rate for Payer: Meridian Medicaid |
$9.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$8.45
|
| Rate for Payer: PACE SWMI |
$8.89
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$8.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.89
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$7.11
|
| Rate for Payer: Railroad Medicare Medicare |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.34
|
| Rate for Payer: UHC Core |
$13.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.89
|
| Rate for Payer: UHC Exchange |
$13.34
|
| Rate for Payer: UHC Medicaid |
$4.65
|
| Rate for Payer: UHCCP Medicaid |
$4.65
|
| Rate for Payer: VA VA |
$8.89
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.16 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.16 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.90
|
| Rate for Payer: BCBS Complete |
$7.43
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$14.42
|
| Rate for Payer: BCN Commercial |
$14.42
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$14.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$20.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.52
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$10.82
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.28
|
| Rate for Payer: UHC Core |
$20.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.52
|
| Rate for Payer: UHC Exchange |
$20.28
|
| Rate for Payer: UHC Medicaid |
$7.07
|
| Rate for Payer: UHCCP Medicaid |
$7.07
|
| Rate for Payer: VA VA |
$13.52
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
OP
|
$43.40
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$39.06 |
| Rate for Payer: Aetna Commercial |
$36.89
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.21
|
| 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 |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$17.13
|
| Rate for Payer: BCN Commercial |
$17.13
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$34.72
|
| Rate for Payer: Cash Price |
$34.72
|
| Rate for Payer: Cofinity Advantage |
$30.38
|
| Rate for Payer: Cofinity Commercial |
$37.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$39.06
|
| Rate for Payer: Mclaren Medicaid |
$8.40
|
| 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 |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.89
|
| Rate for Payer: Nomi Health Commercial |
$24.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.55
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$36.89
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$27.34
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.11
|
| Rate for Payer: UHC Core |
$24.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
IP
|
$43.40
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.34 |
| Max. Negotiated Rate |
$39.06 |
| Rate for Payer: Aetna Commercial |
$36.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.21
|
| Rate for Payer: Cash Price |
$34.72
|
| Rate for Payer: Cofinity Advantage |
$30.38
|
| Rate for Payer: Cofinity Commercial |
$37.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.72
|
| Rate for Payer: Healthscope Commercial |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.55
|
| Rate for Payer: PHP Commercial |
$36.89
|
| Rate for Payer: Priority Health SBD |
$27.34
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
IP
|
$460.87
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$290.35 |
| Max. Negotiated Rate |
$414.78 |
| Rate for Payer: Aetna Commercial |
$391.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.57
|
| Rate for Payer: Cash Price |
$368.70
|
| Rate for Payer: Cofinity Advantage |
$322.61
|
| Rate for Payer: Cofinity Commercial |
$396.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.70
|
| Rate for Payer: Healthscope Commercial |
$414.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.65
|
| Rate for Payer: PHP Commercial |
$391.74
|
| Rate for Payer: Priority Health SBD |
$290.35
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
OP
|
$460.87
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$134.65 |
| Max. Negotiated Rate |
$414.78 |
| Rate for Payer: Aetna Commercial |
$391.74
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$321.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$321.81
|
| Rate for Payer: BCBS Complete |
$141.39
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCBS Trust/PPO |
$274.50
|
| Rate for Payer: BCN Commercial |
$274.50
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$368.70
|
| Rate for Payer: Cash Price |
$368.70
|
| Rate for Payer: Cofinity Advantage |
$322.61
|
| Rate for Payer: Cofinity Commercial |
$396.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$414.78
|
| Rate for Payer: Mclaren Medicaid |
$134.65
|
| Rate for Payer: Mclaren Medicare |
$257.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: Meridian Medicaid |
$270.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.74
|
| Rate for Payer: Nomi Health Commercial |
$386.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.65
|
| Rate for Payer: PACE Medicare |
$244.58
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Commercial |
$391.74
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.45
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health SBD |
$290.35
|
| Rate for Payer: Priority Health Tiered Network |
$205.96
|
| Rate for Payer: Railroad Medicare Medicare |
$257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.18
|
| Rate for Payer: UHC Core |
$386.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.45
|
| Rate for Payer: UHC Exchange |
$386.18
|
| Rate for Payer: UHC Medicaid |
$134.65
|
| Rate for Payer: UHCCP Medicaid |
$134.65
|
| Rate for Payer: VA VA |
$257.45
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
OP
|
$88.43
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.63
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.63
|
| Rate for Payer: BCN Commercial |
$20.63
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Advantage |
$61.90
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$10.12
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$20.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.35
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$55.71
|
| Rate for Payer: Priority Health Tiered Network |
$15.48
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.03
|
| Rate for Payer: UHC Core |
$29.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.35
|
| Rate for Payer: UHC Exchange |
$29.03
|
| Rate for Payer: UHC Medicaid |
$10.12
|
| Rate for Payer: UHCCP Medicaid |
$10.12
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
IP
|
$88.43
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.71 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.48
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Advantage |
$61.90
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: Priority Health SBD |
$55.71
|
|
|
HC HIV ANTIBODY
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$14.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.14
|
| Rate for Payer: BCBS Complete |
$7.53
|
| Rate for Payer: BCBS MAPPO |
$13.71
|
| Rate for Payer: BCBS Trust/PPO |
$14.61
|
| Rate for Payer: BCN Commercial |
$14.61
|
| Rate for Payer: BCN Medicare Advantage |
$13.71
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.71
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Mclaren Medicare |
$13.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$14.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$20.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$13.02
|
| Rate for Payer: PACE SWMI |
$13.71
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$13.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.71
|
| Rate for Payer: Priority Health Medicare |
$13.71
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Priority Health Tiered Network |
$10.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.57
|
| Rate for Payer: UHC Core |
$20.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.71
|
| Rate for Payer: UHC Exchange |
$20.57
|
| Rate for Payer: UHC Medicaid |
$7.17
|
| Rate for Payer: UHCCP Medicaid |
$7.17
|
| Rate for Payer: VA VA |
$13.71
|
|
|
HC HIV ANTIBODY
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.46 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health SBD |
$31.46
|
|
|
HC HIV DNA BY PCR
|
Facility
|
IP
|
$91.26
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.49 |
| Max. Negotiated Rate |
$82.13 |
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.32
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Advantage |
$63.88
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: Priority Health SBD |
$57.49
|
|
|
HC HIV DNA BY PCR
|
Facility
|
OP
|
$91.26
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$82.13 |
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.32
|
| 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 |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Advantage |
$63.88
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| 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 |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$57.49
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
