|
HC PATHOLOGY III DERM
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000111
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.97 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health SBD |
$62.97
|
|
|
HC PATHOLOGY III DERM
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000111
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.28
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS MAPPO |
$48.22
|
| Rate for Payer: BCBS Trust/PPO |
$38.89
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Mclaren Medicaid |
$26.38
|
| Rate for Payer: Mclaren Medicare |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$27.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$48.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.72
|
| Rate for Payer: Priority Health Medicare |
$48.22
|
| Rate for Payer: Priority Health Narrow Network |
$123.78
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$42.24
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
|
HC PATHOLOGY LEVEL I
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 88300
|
| Hospital Charge Code |
31000045
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare |
$27.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.11
|
| Rate for Payer: BCBS Complete |
$15.22
|
| Rate for Payer: BCBS MAPPO |
$26.49
|
| Rate for Payer: BCBS Trust/PPO |
$14.48
|
| Rate for Payer: BCN Medicare Advantage |
$26.49
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Mclaren Medicare |
$26.49
|
| Rate for Payer: Meridian Medicaid |
$15.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.45
|
| Rate for Payer: PACE Medicare |
$25.17
|
| Rate for Payer: PACE SWMI |
$26.49
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: PHP Medicare Advantage |
$26.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.91
|
| Rate for Payer: Priority Health Medicare |
$26.49
|
| Rate for Payer: Priority Health Narrow Network |
$61.53
|
| Rate for Payer: Priority Health SBD |
$27.76
|
| Rate for Payer: Railroad Medicare Medicare |
$26.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.64
|
| Rate for Payer: UHC Core |
$13.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.49
|
| Rate for Payer: UHC Exchange |
$16.04
|
| Rate for Payer: UHC Medicare Advantage |
$27.28
|
| Rate for Payer: VA VA |
$26.49
|
|
|
HC PATHOLOGY LEVEL I
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 88300
|
| Hospital Charge Code |
31000045
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.45
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.84
|
| Rate for Payer: Priority Health SBD |
$27.76
|
|
|
HC PATHOLOGY LEVEL II
|
Facility
|
OP
|
$96.59
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
31000046
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$86.93 |
| Rate for Payer: Aetna Commercial |
$82.10
|
| Rate for Payer: Aetna Medicare |
$27.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.11
|
| Rate for Payer: BCBS Complete |
$15.22
|
| Rate for Payer: BCBS MAPPO |
$26.49
|
| Rate for Payer: BCBS Trust/PPO |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$26.49
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$67.61
|
| Rate for Payer: Cofinity Commercial |
$83.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$86.93
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Mclaren Medicare |
$26.49
|
| Rate for Payer: Meridian Medicaid |
$15.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.10
|
| Rate for Payer: PACE Medicare |
$25.17
|
| Rate for Payer: PACE SWMI |
$26.49
|
| Rate for Payer: PHP Commercial |
$82.10
|
| Rate for Payer: PHP Medicare Advantage |
$26.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.91
|
| Rate for Payer: Priority Health Medicare |
$26.49
|
| Rate for Payer: Priority Health Narrow Network |
$61.53
|
| Rate for Payer: Priority Health SBD |
$60.85
|
| Rate for Payer: Railroad Medicare Medicare |
$26.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.01
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.49
|
| Rate for Payer: UHC Exchange |
$32.74
|
| Rate for Payer: UHC Medicare Advantage |
$27.28
|
| Rate for Payer: VA VA |
$26.49
|
|
|
HC PATHOLOGY LEVEL II
|
Facility
|
IP
|
$96.59
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
31000046
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.85 |
| Max. Negotiated Rate |
$86.93 |
| Rate for Payer: Aetna Commercial |
$82.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.78
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$83.07
|
| Rate for Payer: Cofinity Commercial |
$67.61
|
| Rate for Payer: Healthscope Commercial |
$86.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.10
|
| Rate for Payer: PHP Commercial |
$82.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.61
|
| Rate for Payer: Priority Health SBD |
$60.85
|
|
|
HC PATHOLOGY LEVEL III
|
Facility
|
OP
|
$146.37
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000047
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna Commercial |
$124.41
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.28
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS MAPPO |
$48.22
|
| Rate for Payer: BCBS Trust/PPO |
$38.89
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$117.10
|
| Rate for Payer: Cash Price |
$117.10
|
| Rate for Payer: Cofinity Commercial |
$102.46
|
| Rate for Payer: Cofinity Commercial |
$125.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$131.73
|
| Rate for Payer: Mclaren Medicaid |
$26.38
|
| Rate for Payer: Mclaren Medicare |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$27.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.41
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$124.41
|
| Rate for Payer: PHP Medicare Advantage |
$48.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.72
|
| Rate for Payer: Priority Health Medicare |
$48.22
|
| Rate for Payer: Priority Health Narrow Network |
$123.78
|
| Rate for Payer: Priority Health SBD |
$92.21
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$42.24
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
|
HC PATHOLOGY LEVEL III
|
Facility
|
IP
|
$146.37
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000047
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$92.21 |
| Max. Negotiated Rate |
$131.73 |
| Rate for Payer: Aetna Commercial |
$124.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.14
|
| Rate for Payer: Cash Price |
$117.10
|
| Rate for Payer: Cofinity Commercial |
$102.46
|
| Rate for Payer: Cofinity Commercial |
$125.88
|
| Rate for Payer: Healthscope Commercial |
$131.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.41
|
| Rate for Payer: PHP Commercial |
$124.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.46
|
| Rate for Payer: Priority Health SBD |
$92.21
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
IP
|
$205.02
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.16 |
| Max. Negotiated Rate |
$184.52 |
| Rate for Payer: Aetna Commercial |
$174.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.26
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$143.51
|
| Rate for Payer: Cofinity Commercial |
$176.32
|
| Rate for Payer: Healthscope Commercial |
$184.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$174.27
|
| Rate for Payer: PHP Commercial |
$174.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.51
|
| Rate for Payer: Priority Health SBD |
$129.16
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
OP
|
$205.02
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$184.52 |
| Rate for Payer: Aetna Commercial |
$174.27
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.28
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS MAPPO |
$48.22
|
| Rate for Payer: BCBS Trust/PPO |
$52.24
|
| Rate for Payer: BCCCP Commercial |
$71.93
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$176.32
|
| Rate for Payer: Cofinity Commercial |
$143.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$184.52
|
| Rate for Payer: Mclaren Medicaid |
$26.38
|
| Rate for Payer: Mclaren Medicare |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$27.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$174.27
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$174.27
|
| Rate for Payer: PHP Medicare Advantage |
$48.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.72
|
| Rate for Payer: Priority Health Medicare |
$48.22
|
| Rate for Payer: Priority Health Narrow Network |
$123.78
|
| Rate for Payer: Priority Health SBD |
$129.16
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$44.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health SBD |
$69.30
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.28
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS MAPPO |
$48.22
|
| Rate for Payer: BCBS Trust/PPO |
$52.24
|
| Rate for Payer: BCCCP Commercial |
$71.93
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Mclaren Medicaid |
$26.38
|
| Rate for Payer: Mclaren Medicare |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$27.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PACE Medicare |
$45.81
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$48.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.72
|
| Rate for Payer: Priority Health Medicare |
$48.22
|
| Rate for Payer: Priority Health Narrow Network |
$123.78
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$44.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.22
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$49.67
|
| Rate for Payer: VA VA |
$48.22
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
IP
|
$451.85
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$284.67 |
| Max. Negotiated Rate |
$406.66 |
| Rate for Payer: Aetna Commercial |
$384.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.70
|
| Rate for Payer: Cash Price |
$361.48
|
| Rate for Payer: Cofinity Commercial |
$316.30
|
| Rate for Payer: Cofinity Commercial |
$388.59
|
| Rate for Payer: Healthscope Commercial |
$406.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$384.07
|
| Rate for Payer: PHP Commercial |
$384.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.30
|
| Rate for Payer: Priority Health SBD |
$284.67
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
OP
|
$451.85
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$906.83 |
| Rate for Payer: Aetna Commercial |
$384.07
|
| Rate for Payer: Aetna Medicare |
$332.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.80
|
| Rate for Payer: BCBS Complete |
$183.72
|
| Rate for Payer: BCBS MAPPO |
$319.84
|
| Rate for Payer: BCBS Trust/PPO |
$258.56
|
| Rate for Payer: BCCCP Commercial |
$292.71
|
| Rate for Payer: BCN Medicare Advantage |
$319.84
|
| Rate for Payer: Cash Price |
$361.48
|
| Rate for Payer: Cash Price |
$361.48
|
| Rate for Payer: Cofinity Commercial |
$388.59
|
| Rate for Payer: Cofinity Commercial |
$316.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.84
|
| Rate for Payer: Healthscope Commercial |
$406.66
|
| Rate for Payer: Mclaren Medicaid |
$174.95
|
| Rate for Payer: Mclaren Medicare |
$319.84
|
| Rate for Payer: Meridian Medicaid |
$183.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$384.07
|
| Rate for Payer: PACE Medicare |
$303.85
|
| Rate for Payer: PACE SWMI |
$319.84
|
| Rate for Payer: PHP Commercial |
$384.07
|
| Rate for Payer: PHP Medicare Advantage |
$319.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$906.83
|
| Rate for Payer: Priority Health Medicare |
$319.84
|
| Rate for Payer: Priority Health Narrow Network |
$725.46
|
| Rate for Payer: Priority Health SBD |
$284.67
|
| Rate for Payer: Railroad Medicare Medicare |
$319.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.20
|
| Rate for Payer: UHC Core |
$69.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.84
|
| Rate for Payer: UHC Exchange |
$282.91
|
| Rate for Payer: UHC Medicare Advantage |
$329.44
|
| Rate for Payer: VA VA |
$319.84
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
IP
|
$643.06
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$578.75 |
| Rate for Payer: Aetna Commercial |
$546.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.99
|
| Rate for Payer: Cash Price |
$514.45
|
| Rate for Payer: Cofinity Commercial |
$450.14
|
| Rate for Payer: Cofinity Commercial |
$553.03
|
| Rate for Payer: Healthscope Commercial |
$578.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$546.60
|
| Rate for Payer: PHP Commercial |
$546.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.14
|
| Rate for Payer: Priority Health SBD |
$405.13
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
OP
|
$643.06
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$2,040.47 |
| Rate for Payer: Aetna Commercial |
$546.60
|
| Rate for Payer: Aetna Medicare |
$795.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$956.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$956.40
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$765.12
|
| Rate for Payer: BCBS Trust/PPO |
$365.30
|
| Rate for Payer: BCN Medicare Advantage |
$765.12
|
| Rate for Payer: Cash Price |
$514.45
|
| Rate for Payer: Cash Price |
$514.45
|
| Rate for Payer: Cofinity Commercial |
$450.14
|
| Rate for Payer: Cofinity Commercial |
$553.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.12
|
| Rate for Payer: Healthscope Commercial |
$578.75
|
| Rate for Payer: Mclaren Medicaid |
$418.52
|
| Rate for Payer: Mclaren Medicare |
$765.12
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$803.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$879.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$546.60
|
| Rate for Payer: PACE Medicare |
$726.86
|
| Rate for Payer: PACE SWMI |
$765.12
|
| Rate for Payer: PHP Commercial |
$546.60
|
| Rate for Payer: PHP Medicare Advantage |
$765.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,040.47
|
| Rate for Payer: Priority Health Medicare |
$765.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.38
|
| Rate for Payer: Priority Health SBD |
$405.13
|
| Rate for Payer: Railroad Medicare Medicare |
$765.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.52
|
| Rate for Payer: UHC Core |
$69.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.12
|
| Rate for Payer: UHC Exchange |
$425.02
|
| Rate for Payer: UHC Medicare Advantage |
$788.07
|
| Rate for Payer: VA VA |
$765.12
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.34 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health SBD |
$35.34
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: BCBS Complete |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$23.99
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.80
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Exchange |
$54.36
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.91 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.68
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$62.12
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.43
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.12
|
| Rate for Payer: Priority Health SBD |
$55.91
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$2,040.47 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna Medicare |
$795.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$956.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$956.40
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$765.12
|
| Rate for Payer: BCBS Trust/PPO |
$39.72
|
| Rate for Payer: BCN Medicare Advantage |
$765.12
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$62.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.12
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Mclaren Medicaid |
$418.52
|
| Rate for Payer: Mclaren Medicare |
$765.12
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$803.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$879.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.43
|
| Rate for Payer: PACE Medicare |
$726.86
|
| Rate for Payer: PACE SWMI |
$765.12
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: PHP Medicare Advantage |
$765.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,040.47
|
| Rate for Payer: Priority Health Medicare |
$765.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.38
|
| Rate for Payer: Priority Health SBD |
$55.91
|
| Rate for Payer: Railroad Medicare Medicare |
$765.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.69
|
| Rate for Payer: UHC Core |
$20.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.12
|
| Rate for Payer: UHC Exchange |
$89.72
|
| Rate for Payer: UHC Medicare Advantage |
$788.07
|
| Rate for Payer: VA VA |
$765.12
|
|
|
HC PCP SCREEN URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$95.77 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$48.67
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Cofinity Commercial |
$64.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$58.39
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PCP SCREEN URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.39 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.24
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$64.88
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health SBD |
$58.39
|
|
|
HC PCP SCREEN URN.
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health SBD |
$25.70
|
|
|
HC PCP SCREEN URN.
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$9.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Core |
$17.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$12.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.98
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$295.80
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$186.35 |
| Max. Negotiated Rate |
$266.22 |
| Rate for Payer: Aetna Commercial |
$251.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.27
|
| Rate for Payer: Cash Price |
$236.64
|
| Rate for Payer: Cofinity Commercial |
$207.06
|
| Rate for Payer: Cofinity Commercial |
$254.39
|
| Rate for Payer: Healthscope Commercial |
$266.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$251.43
|
| Rate for Payer: PHP Commercial |
$251.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.06
|
| Rate for Payer: Priority Health SBD |
$186.35
|
|
