|
HC PROPOXYPHENE URINE CMPT
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.39
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Advantage |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health SBD |
$20.73
|
|
|
HC PRO PREDICT 6 MP COMPONENT.
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100629
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$192.05 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Advantage |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.63
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health SBD |
$192.05
|
|
|
HC PRO PREDICT 6 MP COMPONENT.
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100629
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.23
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$25.69
|
| Rate for Payer: BCN Commercial |
$25.69
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Advantage |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Mclaren Medicaid |
$12.60
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.63
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$192.05
|
| Rate for Payer: Priority Health Tiered Network |
$19.27
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.14
|
| Rate for Payer: UHC Core |
$36.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.09
|
| Rate for Payer: UHC Exchange |
$36.14
|
| Rate for Payer: UHC Medicaid |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$12.60
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC PROSTHETIC TRNG INITIAL EACH 15 MIN
|
Facility
|
OP
|
$120.69
|
|
|
Service Code
|
CPT 97761
|
| Hospital Charge Code |
42000040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: Aetna Medicare |
$60.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.45
|
| Rate for Payer: BCBS Complete |
$48.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.81
|
| Rate for Payer: BCN Commercial |
$56.81
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Advantage |
$84.48
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.00
|
| Rate for Payer: Priority Health SBD |
$76.03
|
| Rate for Payer: Priority Health Tiered Network |
$26.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.45
|
| Rate for Payer: UHC Core |
$62.88
|
| Rate for Payer: UHC Exchange |
$47.43
|
|
|
HC PROSTHETIC TRNG INITIAL EACH 15 MIN
|
Facility
|
IP
|
$120.69
|
|
|
Service Code
|
CPT 97761
|
| Hospital Charge Code |
42000040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.45
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Advantage |
$84.48
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: Priority Health SBD |
$76.03
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.39 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health SBD |
$19.39
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
IP
|
$64.73
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.78 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$55.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.07
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cofinity Advantage |
$45.31
|
| Rate for Payer: Cofinity Commercial |
$55.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.78
|
| Rate for Payer: Healthscope Commercial |
$58.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.55
|
| Rate for Payer: PHP Commercial |
$55.02
|
| Rate for Payer: Priority Health SBD |
$40.78
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
OP
|
$64.73
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$55.02
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.30
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: BCBS MAPPO |
$13.84
|
| Rate for Payer: BCBS Trust/PPO |
$14.76
|
| Rate for Payer: BCN Commercial |
$14.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.84
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cofinity Advantage |
$45.31
|
| Rate for Payer: Cofinity Commercial |
$55.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.84
|
| Rate for Payer: Healthscope Commercial |
$58.26
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.53
|
| Rate for Payer: Meridian Medicaid |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.55
|
| Rate for Payer: PACE Medicare |
$13.15
|
| Rate for Payer: PACE SWMI |
$13.84
|
| Rate for Payer: PHP Commercial |
$55.02
|
| Rate for Payer: PHP Medicare Advantage |
$13.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.84
|
| Rate for Payer: Priority Health Medicare |
$13.84
|
| Rate for Payer: Priority Health SBD |
$40.78
|
| Rate for Payer: Priority Health Tiered Network |
$11.07
|
| Rate for Payer: Railroad Medicare Medicare |
$13.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.76
|
| Rate for Payer: UHC Core |
$20.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.84
|
| Rate for Payer: UHC Exchange |
$20.76
|
| Rate for Payer: UHC Medicaid |
$7.24
|
| Rate for Payer: UHCCP Medicaid |
$7.24
|
| Rate for Payer: VA VA |
$13.84
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$36.05 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Advantage |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| 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: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health SBD |
$36.05
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$12.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.01
|
| Rate for Payer: BCBS Complete |
$6.60
|
| Rate for Payer: BCBS MAPPO |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$12.81
|
| Rate for Payer: BCN Commercial |
$12.81
|
| Rate for Payer: BCN Medicare Advantage |
$12.01
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Advantage |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.01
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$6.28
|
| Rate for Payer: Mclaren Medicare |
$12.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.61
|
| Rate for Payer: Meridian Medicaid |
$12.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$18.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PACE Medicare |
$11.41
|
| Rate for Payer: PACE SWMI |
$12.01
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$12.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.01
|
| Rate for Payer: Priority Health Medicare |
$12.01
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: Priority Health Tiered Network |
$9.61
|
| Rate for Payer: Railroad Medicare Medicare |
$12.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.02
|
| Rate for Payer: UHC Core |
$18.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.01
|
| Rate for Payer: UHC Exchange |
$18.02
|
| Rate for Payer: UHC Medicaid |
$6.28
|
| Rate for Payer: UHCCP Medicaid |
$6.28
|
| Rate for Payer: VA VA |
$12.01
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.43
|
| Rate for Payer: BCBS Complete |
$5.90
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS Trust/PPO |
$8.60
|
| Rate for Payer: BCN Commercial |
$8.60
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$5.62
|
| Rate for Payer: Mclaren Medicare |
$10.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$11.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$16.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$10.20
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.74
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$8.59
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.11
|
| Rate for Payer: UHC Core |
$16.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.74
|
| Rate for Payer: UHC Exchange |
$16.11
|
| Rate for Payer: UHC Medicaid |
$5.62
|
| Rate for Payer: UHCCP Medicaid |
$5.62
|
| Rate for Payer: VA VA |
$10.74
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
IP
|
$107.78
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.90 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.06
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Advantage |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: Priority Health SBD |
$67.90
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
OP
|
$107.78
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: Aetna Medicare |
$18.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.29
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS MAPPO |
$17.83
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$14.26
|
| Rate for Payer: BCN Medicare Advantage |
$17.83
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Advantage |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.83
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Mclaren Medicaid |
$9.33
|
| Rate for Payer: Mclaren Medicare |
$17.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.72
|
| Rate for Payer: Meridian Medicaid |
$18.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Nomi Health Commercial |
$26.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PACE Medicare |
$16.94
|
| Rate for Payer: PACE SWMI |
$17.83
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.83
|
| Rate for Payer: Priority Health Medicare |
$17.83
|
| Rate for Payer: Priority Health SBD |
$67.90
|
| Rate for Payer: Priority Health Tiered Network |
$14.26
|
| Rate for Payer: Railroad Medicare Medicare |
$17.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.75
|
| Rate for Payer: UHC Core |
$26.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.83
|
| Rate for Payer: UHC Exchange |
$26.75
|
| Rate for Payer: UHC Medicaid |
$9.33
|
| Rate for Payer: UHCCP Medicaid |
$9.33
|
| Rate for Payer: VA VA |
$17.83
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$16.33
|
| Rate for Payer: BCN Commercial |
$16.33
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Mclaren Medicaid |
$8.01
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.32
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: Priority Health Tiered Network |
$12.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.98
|
| Rate for Payer: UHC Core |
$22.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.32
|
| Rate for Payer: UHC Exchange |
$22.98
|
| Rate for Payer: UHC Medicaid |
$8.01
|
| Rate for Payer: UHCCP Medicaid |
$8.01
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.98 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health SBD |
$39.98
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$88.43
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.71 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.48
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Advantage |
$61.90
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: Priority Health SBD |
$55.71
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
OP
|
$88.43
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$16.33
|
| Rate for Payer: BCN Commercial |
$16.33
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Advantage |
$61.90
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$8.01
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.32
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health SBD |
$55.71
|
| Rate for Payer: Priority Health Tiered Network |
$12.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.98
|
| Rate for Payer: UHC Core |
$22.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.32
|
| Rate for Payer: UHC Exchange |
$22.98
|
| Rate for Payer: UHC Medicaid |
$8.01
|
| Rate for Payer: UHCCP Medicaid |
$8.01
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$31.46 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health SBD |
$31.46
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$4.58
|
| Rate for Payer: BCN Commercial |
$4.58
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$2.24
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$4.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$6.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.29
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Priority Health Tiered Network |
$3.43
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.44
|
| Rate for Payer: UHC Core |
$6.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.29
|
| Rate for Payer: UHC Exchange |
$6.44
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: VA VA |
$4.29
|
|
|
HC PROTIME WITH INR
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$4.58
|
| Rate for Payer: BCN Commercial |
$4.58
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Mclaren Medicaid |
$2.24
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$4.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$6.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.29
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: Priority Health Tiered Network |
$3.43
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.44
|
| Rate for Payer: UHC Core |
$6.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.29
|
| Rate for Payer: UHC Exchange |
$6.44
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: VA VA |
$4.29
|
|
|
HC PROTIME WITH INR
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health SBD |
$18.72
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.19
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$2.32
|
| Rate for Payer: BCN Commercial |
$2.32
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Advantage |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Mclaren Medicaid |
$1.13
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$3.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.17
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: Priority Health Tiered Network |
$1.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$3.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.26
|
| Rate for Payer: UHC Medicaid |
$1.13
|
| Rate for Payer: UHCCP Medicaid |
$1.13
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.40 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Advantage |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health SBD |
$54.40
|
|
