|
HC POC ELECTROLYTES, WHOLE BLOOD
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100766
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: BCBS Complete |
$3.85
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Advantage |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$3.67
|
| Rate for Payer: Mclaren Medicare |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$7.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$10.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.95
|
| Rate for Payer: PACE Medicare |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.01
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Priority Health Tiered Network |
$5.61
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.52
|
| Rate for Payer: UHC Core |
$10.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.01
|
| Rate for Payer: UHC Exchange |
$10.52
|
| Rate for Payer: UHC Medicaid |
$3.67
|
| Rate for Payer: UHCCP Medicaid |
$3.67
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC POC ELECTROLYTES, WHOLE BLOOD
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100766
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Advantage |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.95
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health SBD |
$19.28
|
|
|
HC POC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100763
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
|
|
HC POC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100763
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$4.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.47
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCBS Trust/PPO |
$4.68
|
| Rate for Payer: BCN Commercial |
$4.68
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Meridian Medicaid |
$4.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$13.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$4.16
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.38
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Priority Health Tiered Network |
$3.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.57
|
| Rate for Payer: UHC Core |
$6.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.38
|
| Rate for Payer: UHC Exchange |
$6.57
|
| Rate for Payer: UHC Medicaid |
$2.29
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: VA VA |
$4.38
|
|
|
HC POC GLUCOSE LEVEL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$4.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.91
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$3.93
|
| Rate for Payer: BCN Medicare Advantage |
$3.93
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.93
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$2.06
|
| Rate for Payer: Mclaren Medicare |
$3.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.13
|
| Rate for Payer: Meridian Medicaid |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$11.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$3.73
|
| Rate for Payer: PACE SWMI |
$3.93
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.93
|
| Rate for Payer: Priority Health Medicare |
$3.93
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$3.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.90
|
| Rate for Payer: UHC Core |
$5.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.93
|
| Rate for Payer: UHC Exchange |
$5.90
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: VA VA |
$3.93
|
|
|
HC POC GLUCOSE LEVEL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
|
|
HC POC GLYCOHEMOGLOBIN (A1C)
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
30100764
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.14
|
| Rate for Payer: BCBS Complete |
$5.33
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$10.35
|
| Rate for Payer: BCN Commercial |
$10.35
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$5.08
|
| Rate for Payer: Mclaren Medicare |
$9.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Meridian Medicaid |
$10.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$14.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Medicare |
$9.22
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.71
|
| Rate for Payer: Priority Health Medicare |
$9.71
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: Priority Health Tiered Network |
$7.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.57
|
| Rate for Payer: UHC Core |
$14.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.71
|
| Rate for Payer: UHC Exchange |
$14.57
|
| Rate for Payer: UHC Medicaid |
$5.08
|
| Rate for Payer: UHCCP Medicaid |
$5.08
|
| Rate for Payer: VA VA |
$9.71
|
|
|
HC POC GLYCOHEMOGLOBIN (A1C)
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
30100764
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health SBD |
$23.40
|
|
|
HC POC HEMATOCRIT
|
Facility
|
OP
|
$19.70
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500097
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$17.73 |
| Rate for Payer: Aetna Commercial |
$16.75
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.96
|
| Rate for Payer: BCBS Complete |
$1.30
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCBS Trust/PPO |
$2.53
|
| Rate for Payer: BCN Commercial |
$2.53
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$15.76
|
| Rate for Payer: Cash Price |
$15.76
|
| Rate for Payer: Cofinity Advantage |
$13.79
|
| Rate for Payer: Cofinity Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Healthscope Commercial |
$17.73
|
| Rate for Payer: Mclaren Medicaid |
$1.24
|
| Rate for Payer: Mclaren Medicare |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Meridian Medicaid |
$2.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.75
|
| Rate for Payer: Nomi Health Commercial |
$3.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.78
|
| Rate for Payer: PACE Medicare |
$2.25
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Commercial |
$16.75
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.37
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: Priority Health SBD |
$12.41
|
| Rate for Payer: Priority Health Tiered Network |
$1.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.56
|
| Rate for Payer: UHC Core |
$3.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.37
|
| Rate for Payer: UHC Exchange |
$3.56
|
| Rate for Payer: UHC Medicaid |
$1.24
|
| Rate for Payer: UHCCP Medicaid |
$1.24
|
| Rate for Payer: VA VA |
$2.37
|
|
|
HC POC HEMATOCRIT
|
Facility
|
IP
|
$19.70
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500097
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$17.73 |
| Rate for Payer: Aetna Commercial |
$16.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.80
|
| Rate for Payer: Cash Price |
$15.76
|
| Rate for Payer: Cofinity Advantage |
$13.79
|
| Rate for Payer: Cofinity Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.76
|
| Rate for Payer: Healthscope Commercial |
$17.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.78
|
| Rate for Payer: PHP Commercial |
$16.75
|
| Rate for Payer: Priority Health SBD |
$12.41
|
|
|
HC POC HEMOGLOBIN
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500098
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
|
|
HC POC HEMOGLOBIN
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500098
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.96
|
| Rate for Payer: BCBS Complete |
$1.30
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCBS Trust/PPO |
$2.53
|
| Rate for Payer: BCN Commercial |
$2.53
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$1.24
|
| Rate for Payer: Mclaren Medicare |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Meridian Medicaid |
$2.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$3.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$2.25
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.37
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$1.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.56
|
| Rate for Payer: UHC Core |
$3.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.37
|
| Rate for Payer: UHC Exchange |
$3.56
|
| Rate for Payer: UHC Medicaid |
$1.24
|
| Rate for Payer: UHCCP Medicaid |
$1.24
|
| Rate for Payer: VA VA |
$2.37
|
|
|
HC POC HEMOGLOBIN.
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500109
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.96
|
| Rate for Payer: BCBS Complete |
$1.30
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCBS Trust/PPO |
$2.53
|
| Rate for Payer: BCN Commercial |
$2.53
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$1.24
|
| Rate for Payer: Mclaren Medicare |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Meridian Medicaid |
$2.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$3.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$2.25
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.37
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$1.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.56
|
| Rate for Payer: UHC Core |
$3.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.37
|
| Rate for Payer: UHC Exchange |
$3.56
|
| Rate for Payer: UHC Medicaid |
$1.24
|
| Rate for Payer: UHCCP Medicaid |
$1.24
|
| Rate for Payer: VA VA |
$2.37
|
|
|
HC POC HEMOGLOBIN.
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500109
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
|
|
HC POC HEMOGLOBIN; METHEMOGLOBIN, QUANT
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100725
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
|
|
HC POC HEMOGLOBIN; METHEMOGLOBIN, QUANT
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100725
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$8.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.25
|
| Rate for Payer: BCBS Complete |
$4.50
|
| Rate for Payer: BCBS MAPPO |
$8.20
|
| Rate for Payer: BCBS Trust/PPO |
$8.74
|
| Rate for Payer: BCN Commercial |
$8.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.20
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.20
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$4.29
|
| Rate for Payer: Mclaren Medicare |
$8.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.61
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$7.79
|
| Rate for Payer: PACE SWMI |
$8.20
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$8.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.20
|
| Rate for Payer: Priority Health Medicare |
$8.20
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$6.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.30
|
| Rate for Payer: UHC Core |
$12.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.20
|
| Rate for Payer: UHC Exchange |
$12.30
|
| Rate for Payer: UHC Medicaid |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$4.29
|
| Rate for Payer: VA VA |
$8.20
|
|
|
HC POC IONIZED CALCIUM
|
Facility
|
OP
|
$109.66
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna Medicare |
$14.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.10
|
| Rate for Payer: BCBS Complete |
$7.51
|
| Rate for Payer: BCBS MAPPO |
$13.68
|
| Rate for Payer: BCBS Trust/PPO |
$14.59
|
| Rate for Payer: BCN Commercial |
$14.59
|
| Rate for Payer: BCN Medicare Advantage |
$13.68
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.68
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$7.15
|
| Rate for Payer: Mclaren Medicare |
$13.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.36
|
| Rate for Payer: Meridian Medicaid |
$14.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$20.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PACE Medicare |
$13.00
|
| Rate for Payer: PACE SWMI |
$13.68
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$13.68
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$13.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.52
|
| Rate for Payer: UHC Core |
$20.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.68
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicaid |
$7.15
|
| Rate for Payer: UHCCP Medicaid |
$7.15
|
| Rate for Payer: VA VA |
$13.68
|
|
|
HC POC IONIZED CALCIUM
|
Facility
|
IP
|
$109.66
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.09 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: Priority Health SBD |
$69.09
|
|
|
HC POC KOH PREPARATION
|
Facility
|
IP
|
$24.41
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600343
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$21.97 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$20.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Healthscope Commercial |
$21.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: PHP Commercial |
$20.75
|
| Rate for Payer: Priority Health SBD |
$15.38
|
|
|
HC POC KOH PREPARATION
|
Facility
|
OP
|
$24.41
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600343
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$21.97 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.55
|
| Rate for Payer: BCN Commercial |
$4.55
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$20.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$21.97
|
| Rate for Payer: Mclaren Medicaid |
$2.23
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$6.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$20.75
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.27
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: Priority Health Tiered Network |
$3.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.41
|
| Rate for Payer: UHC Core |
$6.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.41
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC POC LACTIC ACID
|
Facility
|
OP
|
$55.75
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100697
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$50.17 |
| Rate for Payer: Aetna Commercial |
$47.39
|
| Rate for Payer: Aetna Medicare |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$12.34
|
| Rate for Payer: BCN Commercial |
$12.34
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$44.60
|
| Rate for Payer: Cash Price |
$44.60
|
| Rate for Payer: Cofinity Advantage |
$39.02
|
| Rate for Payer: Cofinity Commercial |
$47.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Mclaren Medicaid |
$6.05
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$12.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.39
|
| Rate for Payer: Nomi Health Commercial |
$17.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.81
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$47.39
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.57
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health SBD |
$35.12
|
| Rate for Payer: Priority Health Tiered Network |
$9.26
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.36
|
| Rate for Payer: UHC Core |
$17.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.57
|
| Rate for Payer: UHC Exchange |
$17.36
|
| Rate for Payer: UHC Medicaid |
$6.05
|
| Rate for Payer: UHCCP Medicaid |
$6.05
|
| Rate for Payer: VA VA |
$11.57
|
|
|
HC POC LACTIC ACID
|
Facility
|
IP
|
$55.75
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100697
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$50.17 |
| Rate for Payer: Aetna Commercial |
$47.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.24
|
| Rate for Payer: Cash Price |
$44.60
|
| Rate for Payer: Cofinity Advantage |
$39.02
|
| Rate for Payer: Cofinity Commercial |
$47.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.60
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.81
|
| Rate for Payer: PHP Commercial |
$47.39
|
| Rate for Payer: Priority Health SBD |
$35.12
|
|
|
HC POC LEAD
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100765
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Advantage |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$6.33
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Meridian Medicaid |
$12.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.11
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: Priority Health Tiered Network |
$9.69
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.17
|
| Rate for Payer: UHC Core |
$18.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.11
|
| Rate for Payer: UHC Exchange |
$18.17
|
| Rate for Payer: UHC Medicaid |
$6.33
|
| Rate for Payer: UHCCP Medicaid |
$6.33
|
| Rate for Payer: VA VA |
$12.11
|
|
|
HC POC LEAD
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100765
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.84 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Advantage |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health SBD |
$28.84
|
|
|
HC POC MONO SCREENING MONOSPOT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
|
