|
HC PARVOVIRUS B19 IGG
|
Facility
|
IP
|
$24.58
|
|
|
Service Code
|
CPT 86747
|
| Hospital Charge Code |
30200313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$22.12 |
| Rate for Payer: Aetna Commercial |
$20.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.98
|
| Rate for Payer: Cash Price |
$19.66
|
| Rate for Payer: Cofinity Commercial |
$17.21
|
| Rate for Payer: Cofinity Commercial |
$21.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.66
|
| Rate for Payer: Healthscope Commercial |
$22.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.89
|
| Rate for Payer: PHP Commercial |
$20.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.98
|
| Rate for Payer: Priority Health SBD |
$15.49
|
|
|
HC PARVOVIRUS B19 IGG
|
Facility
|
OP
|
$24.58
|
|
|
Service Code
|
CPT 86747
|
| Hospital Charge Code |
30200313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.06 |
| Max. Negotiated Rate |
$42.31 |
| Rate for Payer: Aetna Commercial |
$20.89
|
| Rate for Payer: Aetna Medicare |
$15.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.79
|
| Rate for Payer: BCBS Complete |
$8.46
|
| Rate for Payer: BCBS MAPPO |
$15.03
|
| Rate for Payer: BCN Medicare Advantage |
$15.03
|
| Rate for Payer: Cash Price |
$19.66
|
| Rate for Payer: Cash Price |
$19.66
|
| Rate for Payer: Cofinity Commercial |
$21.14
|
| Rate for Payer: Cofinity Commercial |
$17.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$22.12
|
| Rate for Payer: Mclaren Medicaid |
$8.06
|
| Rate for Payer: Mclaren Medicare |
$15.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.78
|
| Rate for Payer: Meridian Medicaid |
$8.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.89
|
| Rate for Payer: PACE Medicare |
$14.28
|
| Rate for Payer: PACE SWMI |
$15.03
|
| Rate for Payer: PHP Commercial |
$20.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.98
|
| Rate for Payer: Priority Health Medicare |
$15.03
|
| Rate for Payer: Priority Health SBD |
$15.49
|
| Rate for Payer: Railroad Medicare Medicare |
$15.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.03
|
| Rate for Payer: UHC Medicare Advantage |
$15.03
|
| Rate for Payer: UHCCP Medicaid |
$8.46
|
| Rate for Payer: VA VA |
$15.03
|
|
|
HC PASTE
|
Facility
|
OP
|
$31.09
|
|
| Hospital Charge Code |
27000131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$27.98 |
| Rate for Payer: Aetna Commercial |
$26.43
|
| Rate for Payer: Aetna Medicare |
$15.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.21
|
| Rate for Payer: BCBS Complete |
$12.44
|
| Rate for Payer: Cash Price |
$24.87
|
| Rate for Payer: Cofinity Commercial |
$21.76
|
| Rate for Payer: Cofinity Commercial |
$26.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.87
|
| Rate for Payer: Healthscope Commercial |
$27.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.43
|
| Rate for Payer: PHP Commercial |
$26.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.21
|
| Rate for Payer: Priority Health SBD |
$19.59
|
|
|
HC PASTE
|
Facility
|
IP
|
$31.09
|
|
| Hospital Charge Code |
27000131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$27.98 |
| Rate for Payer: Aetna Commercial |
$26.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.21
|
| Rate for Payer: Cash Price |
$24.87
|
| Rate for Payer: Cofinity Commercial |
$21.76
|
| Rate for Payer: Cofinity Commercial |
$26.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.87
|
| Rate for Payer: Healthscope Commercial |
$27.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.43
|
| Rate for Payer: PHP Commercial |
$26.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.21
|
| Rate for Payer: Priority Health SBD |
$19.59
|
|
|
HC PASTE NO STING
|
Facility
|
OP
|
$42.74
|
|
|
Service Code
|
HCPCS A4406
|
| Hospital Charge Code |
27000627
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.10 |
| Max. Negotiated Rate |
$38.47 |
| Rate for Payer: Aetna Commercial |
$36.33
|
| Rate for Payer: Aetna Medicare |
$21.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.78
|
| Rate for Payer: BCBS Complete |
$17.10
|
| Rate for Payer: Cash Price |
$34.19
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Cofinity Commercial |
$36.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.19
|
| Rate for Payer: Healthscope Commercial |
$38.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.33
|
| Rate for Payer: PHP Commercial |
$36.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.78
|
| Rate for Payer: Priority Health SBD |
$26.93
|
|
|
HC PASTE NO STING
|
Facility
|
IP
|
$42.74
|
|
|
Service Code
|
HCPCS A4406
|
| Hospital Charge Code |
27000627
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$38.47 |
| Rate for Payer: Aetna Commercial |
$36.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.78
|
| Rate for Payer: Cash Price |
$34.19
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Cofinity Commercial |
$36.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.19
|
| Rate for Payer: Healthscope Commercial |
$38.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.33
|
| Rate for Payer: PHP Commercial |
$36.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.78
|
| Rate for Payer: Priority Health SBD |
$26.93
|
|
|
HC PATH CONSULT ON REFERRAL WITH SLIDE PREP
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
31000113
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.48 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health SBD |
$69.48
|
|
|
HC PATH CONSULT ON REFERRAL WITH SLIDE PREP
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
31000113
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$146.68 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$69.48
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY III DERM
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000111
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$146.68 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Cofinity Commercial |
$71.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY III DERM
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000111
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.23 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health SBD |
$64.23
|
|
|
HC PATHOLOGY LEVEL I
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 88300
|
| Hospital Charge Code |
31000045
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.31 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.21
|
| Rate for Payer: Priority Health SBD |
$28.31
|
|
|
HC PATHOLOGY LEVEL I
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 88300
|
| Hospital Charge Code |
31000045
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Cofinity Commercial |
$31.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$28.31
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$13.44
|
| Rate for Payer: VA VA |
$23.88
|
|
|
HC PATHOLOGY LEVEL II
|
Facility
|
IP
|
$98.52
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
31000046
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.07 |
| Max. Negotiated Rate |
$88.67 |
| Rate for Payer: Aetna Commercial |
$83.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.04
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cofinity Commercial |
$68.96
|
| Rate for Payer: Cofinity Commercial |
$84.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.82
|
| Rate for Payer: Healthscope Commercial |
$88.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.74
|
| Rate for Payer: PHP Commercial |
$83.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.04
|
| Rate for Payer: Priority Health SBD |
$62.07
|
|
|
HC PATHOLOGY LEVEL II
|
Facility
|
OP
|
$98.52
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
31000046
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna Commercial |
$83.74
|
| Rate for Payer: Aetna Medicare |
$39.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cofinity Commercial |
$84.73
|
| Rate for Payer: Cofinity Commercial |
$68.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$88.67
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.74
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$83.74
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.04
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health SBD |
$62.07
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$21.55
|
| Rate for Payer: VA VA |
$38.28
|
|
|
HC PATHOLOGY LEVEL III
|
Facility
|
IP
|
$149.30
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000047
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.06 |
| Max. Negotiated Rate |
$134.37 |
| Rate for Payer: Aetna Commercial |
$126.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.05
|
| Rate for Payer: Cash Price |
$119.44
|
| Rate for Payer: Cofinity Commercial |
$104.51
|
| Rate for Payer: Cofinity Commercial |
$128.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.44
|
| Rate for Payer: Healthscope Commercial |
$134.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.91
|
| Rate for Payer: PHP Commercial |
$126.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.05
|
| Rate for Payer: Priority Health SBD |
$94.06
|
|
|
HC PATHOLOGY LEVEL III
|
Facility
|
OP
|
$149.30
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000047
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$146.68 |
| Rate for Payer: Aetna Commercial |
$126.91
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$119.44
|
| Rate for Payer: Cash Price |
$119.44
|
| Rate for Payer: Cofinity Commercial |
$128.40
|
| Rate for Payer: Cofinity Commercial |
$104.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$134.37
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.91
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$126.91
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.05
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$94.06
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
OP
|
$209.12
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$188.21 |
| Rate for Payer: Aetna Commercial |
$177.75
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Cofinity Commercial |
$146.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$146.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$188.21
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$177.75
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.93
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$131.75
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
IP
|
$209.12
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$131.75 |
| Max. Negotiated Rate |
$188.21 |
| Rate for Payer: Aetna Commercial |
$177.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.93
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$146.38
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$146.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Healthscope Commercial |
$188.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: PHP Commercial |
$177.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.93
|
| Rate for Payer: Priority Health SBD |
$131.75
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.69 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health SBD |
$70.69
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$146.68 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
OP
|
$524.15
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$188.04 |
| Max. Negotiated Rate |
$987.55 |
| Rate for Payer: Aetna Commercial |
$445.53
|
| Rate for Payer: Aetna Medicare |
$364.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cofinity Commercial |
$450.77
|
| Rate for Payer: Cofinity Commercial |
$366.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$366.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$471.74
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.53
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$445.53
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.70
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health SBD |
$330.21
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$197.52
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
IP
|
$524.15
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$330.21 |
| Max. Negotiated Rate |
$471.74 |
| Rate for Payer: Aetna Commercial |
$445.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.70
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cofinity Commercial |
$366.90
|
| Rate for Payer: Cofinity Commercial |
$450.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$366.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.32
|
| Rate for Payer: Healthscope Commercial |
$471.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.53
|
| Rate for Payer: PHP Commercial |
$445.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.70
|
| Rate for Payer: Priority Health SBD |
$330.21
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
OP
|
$771.67
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$427.04 |
| Max. Negotiated Rate |
$2,242.66 |
| Rate for Payer: Aetna Commercial |
$655.92
|
| Rate for Payer: Aetna Medicare |
$828.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cofinity Commercial |
$663.64
|
| Rate for Payer: Cofinity Commercial |
$540.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$540.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$694.50
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.92
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$655.92
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.59
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health SBD |
$486.15
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,242.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$448.55
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
IP
|
$771.67
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$486.15 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Aetna Commercial |
$655.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.59
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cofinity Commercial |
$540.17
|
| Rate for Payer: Cofinity Commercial |
$663.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$540.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.34
|
| Rate for Payer: Healthscope Commercial |
$694.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.92
|
| Rate for Payer: PHP Commercial |
$655.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.59
|
| Rate for Payer: Priority Health SBD |
$486.15
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$28.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health SBD |
$36.05
|
|
