|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
IP
|
$73.05
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.14 |
| Max. Negotiated Rate |
$73.05 |
| Rate for Payer: Aetna Commercial |
$65.74
|
| Rate for Payer: ASR ASR |
$70.86
|
| Rate for Payer: BCBS Trust/PPO |
$56.64
|
| Rate for Payer: BCN Commercial |
$56.64
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Cofinity Commercial |
$68.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.44
|
| Rate for Payer: Healthscope Commercial |
$73.05
|
| Rate for Payer: Healthscope Whirlpool |
$70.86
|
| Rate for Payer: Mclaren Commercial |
$65.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.28
|
|
|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
OP
|
$73.05
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$292.46 |
| Rate for Payer: Aetna Commercial |
$65.74
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$70.86
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$56.64
|
| Rate for Payer: BCN Commercial |
$56.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Cofinity Commercial |
$68.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$73.05
|
| Rate for Payer: Healthscope Whirlpool |
$70.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$65.74
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.09
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.46
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$233.97
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.28
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC C1Q BINDING
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$77.70 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna Commercial |
$99.90
|
| Rate for Payer: ASR ASR |
$107.67
|
| Rate for Payer: BCBS Trust/PPO |
$86.06
|
| Rate for Payer: BCN Commercial |
$86.06
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$104.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.80
|
| Rate for Payer: Healthscope Commercial |
$111.00
|
| Rate for Payer: Healthscope Whirlpool |
$107.67
|
| Rate for Payer: Mclaren Commercial |
$99.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.68
|
|
|
HC C1Q BINDING
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna Commercial |
$99.90
|
| Rate for Payer: Aetna Medicare |
$24.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: ASR ASR |
$107.67
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$86.06
|
| Rate for Payer: BCN Commercial |
$86.06
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$104.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$111.00
|
| Rate for Payer: Healthscope Whirlpool |
$107.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.37
|
| Rate for Payer: Mclaren Commercial |
$99.90
|
| Rate for Payer: Mclaren Medicaid |
$13.33
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Medicaid |
$14.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.35
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$26.81
|
| Rate for Payer: PHP Medicaid |
$13.33
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.01
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$78.81
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.10
|
| Rate for Payer: VA VA |
$24.37
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$52.19
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.00
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Mclaren Medicaid |
$6.56
|
| Rate for Payer: Mclaren Medicare |
$12.00
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: PACE Medicare |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$13.20
|
| Rate for Payer: PHP Medicaid |
$6.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.95
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$29.56
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.36
|
| Rate for Payer: VA VA |
$12.00
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Trust/PPO |
$52.19
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
IP
|
$74.64
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.25 |
| Max. Negotiated Rate |
$74.64 |
| Rate for Payer: Aetna Commercial |
$67.18
|
| Rate for Payer: ASR ASR |
$72.40
|
| Rate for Payer: BCBS Trust/PPO |
$57.87
|
| Rate for Payer: BCN Commercial |
$57.87
|
| Rate for Payer: Cash Price |
$59.71
|
| Rate for Payer: Cofinity Commercial |
$70.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.71
|
| Rate for Payer: Healthscope Commercial |
$74.64
|
| Rate for Payer: Healthscope Whirlpool |
$72.40
|
| Rate for Payer: Mclaren Commercial |
$67.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.68
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
OP
|
$74.64
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$92.35 |
| Rate for Payer: Aetna Commercial |
$67.18
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: ASR ASR |
$72.40
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$57.87
|
| Rate for Payer: BCN Commercial |
$57.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$59.71
|
| Rate for Payer: Cash Price |
$59.71
|
| Rate for Payer: Cofinity Commercial |
$70.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$74.64
|
| Rate for Payer: Healthscope Whirlpool |
$72.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.00
|
| Rate for Payer: Mclaren Commercial |
$67.18
|
| Rate for Payer: Mclaren Medicaid |
$6.56
|
| Rate for Payer: Mclaren Medicare |
$12.00
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.44
|
| Rate for Payer: PACE Medicare |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$13.20
|
| Rate for Payer: PHP Medicaid |
$6.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.35
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$73.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.36
|
| Rate for Payer: VA VA |
$12.00
|
|
|
HC CA 125
|
Facility
|
OP
|
$143.10
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$143.10 |
| Rate for Payer: Aetna Commercial |
$128.79
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$138.81
|
| Rate for Payer: BCBS Complete |
$11.95
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$110.95
|
| Rate for Payer: BCN Commercial |
$110.95
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$134.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$143.10
|
| Rate for Payer: Healthscope Whirlpool |
$138.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$128.79
|
| Rate for Payer: Mclaren Medicaid |
$11.38
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Medicaid |
$11.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.64
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.38
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.95
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$29.56
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.93
|
| Rate for Payer: UHC Medicare Advantage |
$21.43
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CA 125
|
Facility
|
IP
|
$143.10
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.17 |
| Max. Negotiated Rate |
$143.10 |
| Rate for Payer: Aetna Commercial |
$128.79
|
| Rate for Payer: ASR ASR |
$138.81
|
| Rate for Payer: BCBS Trust/PPO |
$110.95
|
| Rate for Payer: BCN Commercial |
$110.95
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$134.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.48
|
| Rate for Payer: Healthscope Commercial |
$143.10
|
| Rate for Payer: Healthscope Whirlpool |
$138.81
|
| Rate for Payer: Mclaren Commercial |
$128.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.93
|
|
|
HC CADMIUM LEVEL
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.50 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Aetna Commercial |
$148.50
|
| Rate for Payer: ASR ASR |
$160.05
|
| Rate for Payer: BCBS Trust/PPO |
$127.92
|
| Rate for Payer: BCN Commercial |
$127.92
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$155.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.00
|
| Rate for Payer: Healthscope Commercial |
$165.00
|
| Rate for Payer: Healthscope Whirlpool |
$160.05
|
| Rate for Payer: Mclaren Commercial |
$148.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.20
|
|
|
HC CADMIUM LEVEL
|
Facility
|
OP
|
$165.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Aetna Commercial |
$148.50
|
| Rate for Payer: Aetna Medicare |
$23.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: ASR ASR |
$160.05
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$127.92
|
| Rate for Payer: BCN Commercial |
$127.92
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$155.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$165.00
|
| Rate for Payer: Healthscope Whirlpool |
$160.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.64
|
| Rate for Payer: Mclaren Commercial |
$148.50
|
| Rate for Payer: Mclaren Medicaid |
$12.93
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Medicaid |
$13.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.25
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$26.00
|
| Rate for Payer: PHP Medicaid |
$12.93
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.15
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow Network |
$117.15
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.20
|
| Rate for Payer: UHC Medicare Advantage |
$24.35
|
| Rate for Payer: VA VA |
$23.64
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.68 |
| Max. Negotiated Rate |
$115.26 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: ASR ASR |
$111.80
|
| Rate for Payer: BCBS Trust/PPO |
$89.36
|
| Rate for Payer: BCN Commercial |
$89.36
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$108.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$115.26
|
| Rate for Payer: Healthscope Whirlpool |
$111.80
|
| Rate for Payer: Mclaren Commercial |
$103.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.43
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$115.26 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Medicare |
$38.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: ASR ASR |
$111.80
|
| Rate for Payer: BCBS Complete |
$22.15
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$89.36
|
| Rate for Payer: BCN Commercial |
$89.36
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$108.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$115.26
|
| Rate for Payer: Healthscope Whirlpool |
$111.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.57
|
| Rate for Payer: Mclaren Commercial |
$103.73
|
| Rate for Payer: Mclaren Medicaid |
$21.10
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Medicaid |
$22.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.97
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$42.43
|
| Rate for Payer: PHP Medicaid |
$21.10
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Narrow Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.43
|
| Rate for Payer: UHC Medicare Advantage |
$39.73
|
| Rate for Payer: VA VA |
$38.57
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Trust/PPO |
$52.19
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.65 |
| Max. Negotiated Rate |
$127.24 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.49
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Complete |
$15.39
|
| Rate for Payer: BCBS MAPPO |
$26.79
|
| Rate for Payer: BCBS Trust/PPO |
$52.19
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: BCN Medicare Advantage |
$26.79
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.79
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.79
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Mclaren Medicaid |
$14.65
|
| Rate for Payer: Mclaren Medicare |
$26.79
|
| Rate for Payer: Meridian Medicaid |
$15.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: PACE Medicare |
$25.45
|
| Rate for Payer: PACE SWMI |
$26.79
|
| Rate for Payer: PHP Commercial |
$29.47
|
| Rate for Payer: PHP Medicaid |
$14.65
|
| Rate for Payer: PHP Medicare Advantage |
$26.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.24
|
| Rate for Payer: Priority Health Medicare |
$26.79
|
| Rate for Payer: Priority Health Narrow Network |
$101.79
|
| Rate for Payer: Railroad Medicare Medicare |
$26.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
| Rate for Payer: UHC Medicare Advantage |
$27.59
|
| Rate for Payer: VA VA |
$26.79
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$26.35
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.44 |
| Max. Negotiated Rate |
$26.35 |
| Rate for Payer: Aetna Commercial |
$23.72
|
| Rate for Payer: ASR ASR |
$25.56
|
| Rate for Payer: BCBS Trust/PPO |
$20.43
|
| Rate for Payer: BCN Commercial |
$20.43
|
| Rate for Payer: Cash Price |
$21.08
|
| Rate for Payer: Cofinity Commercial |
$24.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.08
|
| Rate for Payer: Healthscope Commercial |
$26.35
|
| Rate for Payer: Healthscope Whirlpool |
$25.56
|
| Rate for Payer: Mclaren Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.19
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
OP
|
$26.35
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$26.35 |
| Rate for Payer: Aetna Commercial |
$23.72
|
| Rate for Payer: ASR ASR |
$25.56
|
| Rate for Payer: BCBS Complete |
$10.54
|
| Rate for Payer: BCBS Trust/PPO |
$20.43
|
| Rate for Payer: BCN Commercial |
$20.43
|
| Rate for Payer: Cash Price |
$21.08
|
| Rate for Payer: Cofinity Commercial |
$24.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.08
|
| Rate for Payer: Healthscope Commercial |
$26.35
|
| Rate for Payer: Healthscope Whirlpool |
$25.56
|
| Rate for Payer: Mclaren Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.98
|
| Rate for Payer: Priority Health Narrow Network |
$18.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.19
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$18.51
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$18.51 |
| Rate for Payer: Aetna Commercial |
$16.66
|
| Rate for Payer: ASR ASR |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$14.35
|
| Rate for Payer: BCN Commercial |
$14.35
|
| Rate for Payer: Cash Price |
$14.81
|
| Rate for Payer: Cofinity Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.81
|
| Rate for Payer: Healthscope Commercial |
$18.51
|
| Rate for Payer: Healthscope Whirlpool |
$17.95
|
| Rate for Payer: Mclaren Commercial |
$16.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.29
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$18.51
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$18.51 |
| Rate for Payer: Aetna Commercial |
$16.66
|
| Rate for Payer: ASR ASR |
$17.95
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$14.35
|
| Rate for Payer: BCN Commercial |
$14.35
|
| Rate for Payer: Cash Price |
$14.81
|
| Rate for Payer: Cofinity Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.81
|
| Rate for Payer: Healthscope Commercial |
$18.51
|
| Rate for Payer: Healthscope Whirlpool |
$17.95
|
| Rate for Payer: Mclaren Commercial |
$16.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.84
|
| Rate for Payer: Priority Health Narrow Network |
$13.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.29
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$5.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$2.96
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.16
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.16
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$2.82
|
| Rate for Payer: Mclaren Medicare |
$5.16
|
| Rate for Payer: Meridian Medicaid |
$2.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$4.90
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PHP Commercial |
$5.68
|
| Rate for Payer: PHP Medicaid |
$2.82
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.98
|
| Rate for Payer: Priority Health Medicare |
$5.16
|
| Rate for Payer: Priority Health Narrow Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: VA VA |
$5.16
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$52.80 |
| Rate for Payer: Aetna Commercial |
$47.52
|
| Rate for Payer: Aetna Medicare |
$6.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.54
|
| Rate for Payer: ASR ASR |
$51.22
|
| Rate for Payer: BCBS Complete |
$3.46
|
| Rate for Payer: BCBS MAPPO |
$6.03
|
| Rate for Payer: BCBS Trust/PPO |
$40.94
|
| Rate for Payer: BCN Commercial |
$40.94
|
| Rate for Payer: BCN Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$49.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.03
|
| Rate for Payer: Healthscope Commercial |
$52.80
|
| Rate for Payer: Healthscope Whirlpool |
$51.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.03
|
| Rate for Payer: Mclaren Commercial |
$47.52
|
| Rate for Payer: Mclaren Medicaid |
$3.30
|
| Rate for Payer: Mclaren Medicare |
$6.03
|
| Rate for Payer: Meridian Medicaid |
$3.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PACE Medicare |
$5.73
|
| Rate for Payer: PACE SWMI |
$6.03
|
| Rate for Payer: PHP Commercial |
$6.63
|
| Rate for Payer: PHP Medicaid |
$3.30
|
| Rate for Payer: PHP Medicare Advantage |
$6.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.70
|
| Rate for Payer: Priority Health Medicare |
$6.03
|
| Rate for Payer: Priority Health Narrow Network |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.46
|
| Rate for Payer: UHC Medicare Advantage |
$6.21
|
| Rate for Payer: VA VA |
$6.03
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.96 |
| Max. Negotiated Rate |
$52.80 |
| Rate for Payer: Aetna Commercial |
$47.52
|
| Rate for Payer: ASR ASR |
$51.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.94
|
| Rate for Payer: BCN Commercial |
$40.94
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$49.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$52.80
|
| Rate for Payer: Healthscope Whirlpool |
$51.22
|
| Rate for Payer: Mclaren Commercial |
$47.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.46
|
|
|
HC CALCULI
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.27 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$39.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$40.57
|
| Rate for Payer: Mclaren Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
|
