|
HC HIV QUANTITATIVE
|
Facility
|
IP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$95.98 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.03
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Advantage |
$106.64
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: Priority Health SBD |
$95.98
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
OP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.51 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: BCBS Complete |
$46.74
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCBS Trust/PPO |
$90.74
|
| Rate for Payer: BCN Commercial |
$90.74
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Advantage |
$106.64
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Mclaren Medicaid |
$44.51
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$89.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$127.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.10
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health SBD |
$95.98
|
| Rate for Payer: Priority Health Tiered Network |
$68.08
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.65
|
| Rate for Payer: UHC Core |
$127.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.10
|
| Rate for Payer: UHC Exchange |
$127.65
|
| Rate for Payer: UHC Medicaid |
$44.51
|
| Rate for Payer: UHCCP Medicaid |
$44.51
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA BY PCR
|
Facility
|
IP
|
$212.24
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$133.71 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.96
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Advantage |
$148.57
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: Priority Health SBD |
$133.71
|
|
|
HC HIV RNA BY PCR
|
Facility
|
OP
|
$212.24
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.51 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: BCBS Complete |
$46.74
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCBS Trust/PPO |
$90.74
|
| Rate for Payer: BCN Commercial |
$90.74
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Advantage |
$148.57
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Mclaren Medicaid |
$44.51
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$89.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$127.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.10
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health SBD |
$133.71
|
| Rate for Payer: Priority Health Tiered Network |
$68.08
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.65
|
| Rate for Payer: UHC Core |
$127.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.10
|
| Rate for Payer: UHC Exchange |
$127.65
|
| Rate for Payer: UHC Medicaid |
$44.51
|
| Rate for Payer: UHCCP Medicaid |
$44.51
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
OP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.51 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: BCBS Complete |
$46.74
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCBS Trust/PPO |
$90.74
|
| Rate for Payer: BCN Commercial |
$90.74
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Advantage |
$106.64
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Mclaren Medicaid |
$44.51
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$89.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$127.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.10
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health SBD |
$95.98
|
| Rate for Payer: Priority Health Tiered Network |
$68.08
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.65
|
| Rate for Payer: UHC Core |
$127.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.10
|
| Rate for Payer: UHC Exchange |
$127.65
|
| Rate for Payer: UHC Medicaid |
$44.51
|
| Rate for Payer: UHCCP Medicaid |
$44.51
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
IP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$95.98 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.03
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Advantage |
$106.64
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: Priority Health SBD |
$95.98
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| 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 |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Advantage |
$73.56
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| 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 |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.81
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$89.32
|
| 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 |
$66.20
|
| 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 TYPE 1 AB IFA
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.20 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Advantage |
$73.56
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.81
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health SBD |
$66.20
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.82 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Advantage |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health SBD |
$68.82
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| 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 |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Advantage |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| 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 |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$92.85
|
| 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 |
$68.82
|
| 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 TYPE 2 ANTIBODY
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| 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 |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| 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 |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$20.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$58.63
|
| 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 |
$43.46
|
| 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 TYPE 2 ANTIBODY
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.46 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health SBD |
$43.46
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
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 WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| 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 |
$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 |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| 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 |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$66.33
|
| 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 |
$49.16
|
| 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 HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$283.48
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$178.59 |
| Max. Negotiated Rate |
$255.13 |
| Rate for Payer: Aetna Commercial |
$240.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.26
|
| Rate for Payer: Cash Price |
$226.78
|
| Rate for Payer: Cofinity Advantage |
$198.44
|
| Rate for Payer: Cofinity Commercial |
$243.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.78
|
| Rate for Payer: Healthscope Commercial |
$255.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.61
|
| Rate for Payer: PHP Commercial |
$240.96
|
| Rate for Payer: Priority Health SBD |
$178.59
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$283.48
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.86 |
| Max. Negotiated Rate |
$509.70 |
| Rate for Payer: Aetna Commercial |
$240.96
|
| Rate for Payer: Aetna Medicare |
$176.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.38
|
| Rate for Payer: BCBS Complete |
$93.31
|
| Rate for Payer: BCBS MAPPO |
$169.90
|
| Rate for Payer: BCBS Trust/PPO |
$181.15
|
| Rate for Payer: BCN Commercial |
$181.15
|
| Rate for Payer: BCN Medicare Advantage |
$169.90
|
| Rate for Payer: Cash Price |
$226.78
|
| Rate for Payer: Cash Price |
$226.78
|
| Rate for Payer: Cofinity Advantage |
$198.44
|
| Rate for Payer: Cofinity Commercial |
$243.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.90
|
| Rate for Payer: Healthscope Commercial |
$255.13
|
| Rate for Payer: Mclaren Medicaid |
$88.86
|
| Rate for Payer: Mclaren Medicare |
$169.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.40
|
| Rate for Payer: Meridian Medicaid |
$178.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.96
|
| Rate for Payer: Nomi Health Commercial |
$509.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.61
|
| Rate for Payer: PACE Medicare |
$161.41
|
| Rate for Payer: PACE SWMI |
$169.90
|
| Rate for Payer: PHP Commercial |
$240.96
|
| Rate for Payer: PHP Medicare Advantage |
$169.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.90
|
| Rate for Payer: Priority Health Medicare |
$169.90
|
| Rate for Payer: Priority Health SBD |
$178.59
|
| Rate for Payer: Priority Health Tiered Network |
$135.92
|
| Rate for Payer: Railroad Medicare Medicare |
$169.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.85
|
| Rate for Payer: UHC Core |
$254.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.90
|
| Rate for Payer: UHC Exchange |
$254.85
|
| Rate for Payer: UHC Medicaid |
$88.86
|
| Rate for Payer: UHCCP Medicaid |
$88.86
|
| Rate for Payer: VA VA |
$169.90
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| 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 HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$14.17
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$27.52
|
| Rate for Payer: BCN Commercial |
$27.52
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| 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 |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Mclaren Medicaid |
$13.50
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$27.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$38.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.81
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health SBD |
$32.09
|
| Rate for Payer: Priority Health Tiered Network |
$20.65
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$38.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.81
|
| Rate for Payer: UHC Exchange |
$38.72
|
| Rate for Payer: UHC Medicaid |
$13.50
|
| Rate for Payer: UHCCP Medicaid |
$13.50
|
| Rate for Payer: VA VA |
$25.81
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,811.89
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,771.49 |
| Max. Negotiated Rate |
$2,530.70 |
| Rate for Payer: Aetna Commercial |
$2,390.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,827.73
|
| Rate for Payer: Cash Price |
$2,249.51
|
| Rate for Payer: Cofinity Advantage |
$1,968.32
|
| Rate for Payer: Cofinity Commercial |
$2,418.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,249.51
|
| Rate for Payer: Healthscope Commercial |
$2,530.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,390.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,108.92
|
| Rate for Payer: PHP Commercial |
$2,390.11
|
| Rate for Payer: Priority Health SBD |
$1,771.49
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,811.89
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$361.16 |
| Max. Negotiated Rate |
$2,530.70 |
| Rate for Payer: Aetna Commercial |
$2,390.11
|
| Rate for Payer: Aetna Medicare |
$718.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,827.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$863.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$863.20
|
| Rate for Payer: BCBS Complete |
$379.26
|
| Rate for Payer: BCBS MAPPO |
$690.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,161.19
|
| Rate for Payer: BCN Commercial |
$2,161.19
|
| Rate for Payer: BCN Medicare Advantage |
$690.56
|
| Rate for Payer: Cash Price |
$2,249.51
|
| Rate for Payer: Cash Price |
$2,249.51
|
| Rate for Payer: Cofinity Advantage |
$1,968.32
|
| Rate for Payer: Cofinity Commercial |
$2,418.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,249.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.56
|
| Rate for Payer: Healthscope Commercial |
$2,530.70
|
| Rate for Payer: Mclaren Medicaid |
$361.16
|
| Rate for Payer: Mclaren Medicare |
$690.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$725.09
|
| Rate for Payer: Meridian Medicaid |
$725.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$794.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$759.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,390.11
|
| Rate for Payer: Nomi Health Commercial |
$2,071.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,108.92
|
| Rate for Payer: PACE Medicare |
$656.03
|
| Rate for Payer: PACE SWMI |
$690.56
|
| Rate for Payer: PHP Commercial |
$2,390.11
|
| Rate for Payer: PHP Medicare Advantage |
$690.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,233.21
|
| Rate for Payer: Priority Health Medicare |
$690.56
|
| Rate for Payer: Priority Health SBD |
$1,771.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,786.57
|
| Rate for Payer: Railroad Medicare Medicare |
$690.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,827.73
|
| Rate for Payer: UHC Core |
$1,464.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$690.56
|
| Rate for Payer: UHC Exchange |
$1,105.07
|
| Rate for Payer: UHC Medicaid |
$361.16
|
| Rate for Payer: UHCCP Medicaid |
$361.16
|
| Rate for Payer: VA VA |
$690.56
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$679.03
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$427.79 |
| Max. Negotiated Rate |
$611.13 |
| Rate for Payer: Aetna Commercial |
$577.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.37
|
| Rate for Payer: Cash Price |
$543.22
|
| Rate for Payer: Cofinity Advantage |
$475.32
|
| Rate for Payer: Cofinity Commercial |
$583.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.22
|
| Rate for Payer: Healthscope Commercial |
$611.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$577.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$509.27
|
| Rate for Payer: PHP Commercial |
$577.18
|
| Rate for Payer: Priority Health SBD |
$427.79
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$679.03
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$611.13 |
| Rate for Payer: Aetna Commercial |
$577.18
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$78.47
|
| Rate for Payer: BCN Commercial |
$78.47
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$543.22
|
| Rate for Payer: Cash Price |
$543.22
|
| Rate for Payer: Cofinity Advantage |
$475.32
|
| Rate for Payer: Cofinity Commercial |
$583.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$611.13
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$577.18
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$509.27
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$577.18
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$427.79
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.37
|
| Rate for Payer: UHC Core |
$353.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$266.86
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,074.74
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$967.27 |
| Rate for Payer: Aetna Commercial |
$913.53
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$151.02
|
| Rate for Payer: BCN Commercial |
$151.02
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$859.79
|
| Rate for Payer: Cash Price |
$859.79
|
| Rate for Payer: Cofinity Advantage |
$752.32
|
| Rate for Payer: Cofinity Commercial |
$924.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$967.27
|
| Rate for Payer: Mclaren Medicaid |
$30.74
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.53
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.05
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$913.53
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$677.09
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.58
|
| Rate for Payer: UHC Core |
$559.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$422.37
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,074.74
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$677.09 |
| Max. Negotiated Rate |
$967.27 |
| Rate for Payer: Aetna Commercial |
$913.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.58
|
| Rate for Payer: Cash Price |
$859.79
|
| Rate for Payer: Cofinity Advantage |
$752.32
|
| Rate for Payer: Cofinity Commercial |
$924.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.79
|
| Rate for Payer: Healthscope Commercial |
$967.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.05
|
| Rate for Payer: PHP Commercial |
$913.53
|
| Rate for Payer: Priority Health SBD |
$677.09
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
IP
|
$216.41
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$136.34 |
| Max. Negotiated Rate |
$194.77 |
| Rate for Payer: Aetna Commercial |
$183.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.67
|
| Rate for Payer: Cash Price |
$173.13
|
| Rate for Payer: Cofinity Advantage |
$151.49
|
| Rate for Payer: Cofinity Commercial |
$186.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.13
|
| Rate for Payer: Healthscope Commercial |
$194.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.31
|
| Rate for Payer: PHP Commercial |
$183.95
|
| Rate for Payer: Priority Health SBD |
$136.34
|
|
