|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| 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 RESERVOIR VEN STAND ALONE
|
Facility
|
OP
|
$858.33
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$337.32 |
| Max. Negotiated Rate |
$772.50 |
| Rate for Payer: Aetna Commercial |
$729.58
|
| Rate for Payer: Aetna Medicare |
$429.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.91
|
| Rate for Payer: BCBS Complete |
$343.33
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Advantage |
$600.83
|
| Rate for Payer: Cofinity Commercial |
$738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$772.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: PHP Commercial |
$729.58
|
| Rate for Payer: Priority Health SBD |
$540.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.91
|
| Rate for Payer: UHC Core |
$447.19
|
| Rate for Payer: UHC Exchange |
$337.32
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
IP
|
$858.33
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$540.75 |
| Max. Negotiated Rate |
$772.50 |
| Rate for Payer: Aetna Commercial |
$729.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.91
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Advantage |
$600.83
|
| Rate for Payer: Cofinity Commercial |
$738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$772.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: PHP Commercial |
$729.58
|
| Rate for Payer: Priority Health SBD |
$540.75
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
IP
|
$181.98
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$114.65 |
| Max. Negotiated Rate |
$163.78 |
| Rate for Payer: Aetna Commercial |
$154.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.29
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cofinity Advantage |
$127.39
|
| Rate for Payer: Cofinity Commercial |
$156.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.58
|
| Rate for Payer: Healthscope Commercial |
$163.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.49
|
| Rate for Payer: PHP Commercial |
$154.68
|
| Rate for Payer: Priority Health SBD |
$114.65
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
OP
|
$181.98
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$71.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna Commercial |
$154.68
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$111.05
|
| Rate for Payer: BCN Commercial |
$111.05
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cofinity Advantage |
$127.39
|
| Rate for Payer: Cofinity Commercial |
$156.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$163.78
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.68
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.49
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$154.68
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$114.65
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.29
|
| Rate for Payer: UHC Core |
$94.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$71.52
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$1,075.70
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$422.75 |
| Max. Negotiated Rate |
$968.13 |
| Rate for Payer: Aetna Commercial |
$914.35
|
| Rate for Payer: Aetna Medicare |
$537.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.21
|
| Rate for Payer: BCBS Complete |
$430.28
|
| Rate for Payer: BCBS Trust/PPO |
$674.62
|
| Rate for Payer: BCN Commercial |
$674.62
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cofinity Advantage |
$752.99
|
| Rate for Payer: Cofinity Commercial |
$925.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.56
|
| Rate for Payer: Healthscope Commercial |
$968.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.77
|
| Rate for Payer: PHP Commercial |
$914.35
|
| Rate for Payer: Priority Health SBD |
$677.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.21
|
| Rate for Payer: UHC Core |
$560.44
|
| Rate for Payer: UHC Exchange |
$422.75
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,075.70
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$677.69 |
| Max. Negotiated Rate |
$968.13 |
| Rate for Payer: Aetna Commercial |
$914.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.21
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cofinity Advantage |
$752.99
|
| Rate for Payer: Cofinity Commercial |
$925.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.56
|
| Rate for Payer: Healthscope Commercial |
$968.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.77
|
| Rate for Payer: PHP Commercial |
$914.35
|
| Rate for Payer: Priority Health SBD |
$677.69
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$103.62
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$93.26 |
| Rate for Payer: Aetna Commercial |
$88.08
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$13.97
|
| Rate for Payer: BCN Commercial |
$13.97
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cofinity Advantage |
$72.53
|
| Rate for Payer: Cofinity Commercial |
$89.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$93.26
|
| Rate for Payer: Mclaren Medicaid |
$6.85
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.08
|
| Rate for Payer: Nomi Health Commercial |
$19.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.72
|
| Rate for Payer: PACE Medicare |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$88.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.10
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health SBD |
$65.28
|
| Rate for Payer: Priority Health Tiered Network |
$10.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.65
|
| Rate for Payer: UHC Core |
$19.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.10
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$13.10
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$103.62
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.28 |
| Max. Negotiated Rate |
$93.26 |
| Rate for Payer: Aetna Commercial |
$88.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.35
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cofinity Advantage |
$72.53
|
| Rate for Payer: Cofinity Commercial |
$89.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.90
|
| Rate for Payer: Healthscope Commercial |
$93.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.72
|
| Rate for Payer: PHP Commercial |
$88.08
|
| Rate for Payer: Priority Health SBD |
$65.28
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$74.70
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.06 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.55
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Advantage |
$52.29
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.02
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: Priority Health SBD |
$47.06
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$74.70
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna Medicare |
$13.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.77
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$14.32
|
| Rate for Payer: BCN Commercial |
$14.32
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Advantage |
$52.29
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Nomi Health Commercial |
$20.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.02
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.42
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health SBD |
$47.06
|
| Rate for Payer: Priority Health Tiered Network |
$10.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.13
|
| Rate for Payer: UHC Core |
$20.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.42
|
| Rate for Payer: UHC Exchange |
$20.13
|
| Rate for Payer: UHC Medicaid |
$7.02
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: VA VA |
$13.42
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Mclaren Medicaid |
$6.27
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$45.23
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.23 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: Priority Health SBD |
$45.23
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$5,130.98
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$228.42 |
| Max. Negotiated Rate |
$4,617.88 |
| Rate for Payer: Aetna Commercial |
$4,361.33
|
| Rate for Payer: Aetna Medicare |
$454.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,335.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.94
|
| Rate for Payer: BCBS Complete |
$239.86
|
| Rate for Payer: BCBS MAPPO |
$436.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,483.19
|
| Rate for Payer: BCN Commercial |
$4,483.19
|
| Rate for Payer: BCN Medicare Advantage |
$436.75
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cofinity Advantage |
$3,591.69
|
| Rate for Payer: Cofinity Commercial |
$4,412.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,104.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.75
|
| Rate for Payer: Healthscope Commercial |
$4,617.88
|
| Rate for Payer: Mclaren Medicaid |
$228.42
|
| Rate for Payer: Mclaren Medicare |
$436.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.59
|
| Rate for Payer: Meridian Medicaid |
$458.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,361.33
|
| Rate for Payer: Nomi Health Commercial |
$1,310.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,848.24
|
| Rate for Payer: PACE Medicare |
$414.91
|
| Rate for Payer: PACE SWMI |
$436.75
|
| Rate for Payer: PHP Commercial |
$4,361.33
|
| Rate for Payer: PHP Medicare Advantage |
$436.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,377.51
|
| Rate for Payer: Priority Health Medicare |
$436.75
|
| Rate for Payer: Priority Health SBD |
$3,232.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.01
|
| Rate for Payer: Railroad Medicare Medicare |
$436.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.43
|
| Rate for Payer: UHC Core |
$480.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.75
|
| Rate for Payer: UHC Exchange |
$480.43
|
| Rate for Payer: UHC Medicaid |
$228.42
|
| Rate for Payer: UHCCP Medicaid |
$228.42
|
| Rate for Payer: VA VA |
$436.75
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$5,130.98
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,232.52 |
| Max. Negotiated Rate |
$4,617.88 |
| Rate for Payer: Aetna Commercial |
$4,361.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,335.14
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cofinity Advantage |
$3,591.69
|
| Rate for Payer: Cofinity Commercial |
$4,412.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,104.78
|
| Rate for Payer: Healthscope Commercial |
$4,617.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,361.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,848.24
|
| Rate for Payer: PHP Commercial |
$4,361.33
|
| Rate for Payer: Priority Health SBD |
$3,232.52
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Advantage |
$16.42
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.59
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health SBD |
$14.78
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$13.97
|
| Rate for Payer: BCN Commercial |
$13.97
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Advantage |
$16.42
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Mclaren Medicaid |
$6.85
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: Nomi Health Commercial |
$19.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.59
|
| Rate for Payer: PACE Medicare |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.10
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: Priority Health Tiered Network |
$10.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.65
|
| Rate for Payer: UHC Core |
$19.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.10
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$13.10
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.11 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
