|
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
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$454.36
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$318.05 |
| Max. Negotiated Rate |
$454.36 |
| Rate for Payer: Aetna Commercial |
$408.92
|
| Rate for Payer: ASR ASR |
$440.73
|
| Rate for Payer: BCBS Trust/PPO |
$352.27
|
| Rate for Payer: BCN Commercial |
$352.27
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$427.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Healthscope Commercial |
$454.36
|
| Rate for Payer: Healthscope Whirlpool |
$440.73
|
| Rate for Payer: Mclaren Commercial |
$408.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.84
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$454.36
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$454.36 |
| Rate for Payer: Aetna Commercial |
$408.92
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$440.73
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$352.27
|
| Rate for Payer: BCN Commercial |
$352.27
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$427.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$454.36
|
| Rate for Payer: Healthscope Whirlpool |
$440.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$408.92
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.47
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$322.60
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.84
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$454.36
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$454.36 |
| Rate for Payer: Aetna Commercial |
$408.92
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$440.73
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$352.27
|
| Rate for Payer: BCN Commercial |
$352.27
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$427.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$454.36
|
| Rate for Payer: Healthscope Whirlpool |
$440.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$408.92
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.47
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$322.60
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.84
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$454.36
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$318.05 |
| Max. Negotiated Rate |
$454.36 |
| Rate for Payer: Aetna Commercial |
$408.92
|
| Rate for Payer: ASR ASR |
$440.73
|
| Rate for Payer: BCBS Trust/PPO |
$352.27
|
| Rate for Payer: BCN Commercial |
$352.27
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$427.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Healthscope Commercial |
$454.36
|
| Rate for Payer: Healthscope Whirlpool |
$440.73
|
| Rate for Payer: Mclaren Commercial |
$408.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.84
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$232.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$232.00 |
| Rate for Payer: Aetna Commercial |
$208.80
|
| Rate for Payer: ASR ASR |
$225.04
|
| Rate for Payer: BCBS Trust/PPO |
$179.87
|
| Rate for Payer: BCN Commercial |
$179.87
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$218.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.60
|
| Rate for Payer: Healthscope Commercial |
$232.00
|
| Rate for Payer: Healthscope Whirlpool |
$225.04
|
| Rate for Payer: Mclaren Commercial |
$208.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$197.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.16
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$232.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$232.00 |
| Rate for Payer: Aetna Commercial |
$208.80
|
| Rate for Payer: Aetna Medicare |
$19.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: ASR ASR |
$225.04
|
| Rate for Payer: BCBS Complete |
$11.28
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$179.87
|
| Rate for Payer: BCN Commercial |
$179.87
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$218.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$232.00
|
| Rate for Payer: Healthscope Whirlpool |
$225.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.63
|
| Rate for Payer: Mclaren Commercial |
$208.80
|
| Rate for Payer: Mclaren Medicaid |
$10.74
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Medicaid |
$11.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$197.20
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$21.59
|
| Rate for Payer: PHP Medicaid |
$10.74
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.12
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health Narrow Network |
$164.72
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.16
|
| Rate for Payer: UHC Medicare Advantage |
$20.22
|
| Rate for Payer: VA VA |
$19.63
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: Aetna Medicare |
$19.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: ASR ASR |
$38.80
|
| Rate for Payer: BCBS Complete |
$11.28
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$31.01
|
| Rate for Payer: BCN Commercial |
$31.01
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$37.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$40.00
|
| Rate for Payer: Healthscope Whirlpool |
$38.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.63
|
| Rate for Payer: Mclaren Commercial |
$36.00
|
| Rate for Payer: Mclaren Medicaid |
$10.74
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Medicaid |
$11.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.00
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$21.59
|
| Rate for Payer: PHP Medicaid |
$10.74
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health Narrow Network |
$28.40
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.20
|
| Rate for Payer: UHC Medicare Advantage |
$20.22
|
| Rate for Payer: VA VA |
$19.63
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: ASR ASR |
$38.80
|
| Rate for Payer: BCBS Trust/PPO |
$31.01
|
| Rate for Payer: BCN Commercial |
$31.01
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$37.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$40.00
|
| Rate for Payer: Healthscope Whirlpool |
$38.80
|
| Rate for Payer: Mclaren Commercial |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.20
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$660.04
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.53 |
| Max. Negotiated Rate |
$660.04 |
| Rate for Payer: Aetna Commercial |
$594.04
|
| Rate for Payer: Aetna Medicare |
$121.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: ASR ASR |
$640.24
|
| Rate for Payer: BCBS Complete |
$69.86
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$511.73
|
| Rate for Payer: BCN Commercial |
$511.73
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$528.03
|
| Rate for Payer: Cash Price |
$528.03
|
| Rate for Payer: Cofinity Commercial |
$620.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$660.04
|
| Rate for Payer: Healthscope Whirlpool |
$640.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$121.63
|
| Rate for Payer: Mclaren Commercial |
$594.04
|
| Rate for Payer: Mclaren Medicaid |
$66.53
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Medicaid |
$69.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.03
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$133.79
|
| Rate for Payer: PHP Medicaid |
$66.53
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.64
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health Narrow Network |
$468.63
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.84
|
| Rate for Payer: UHC Medicare Advantage |
$125.28
|
| Rate for Payer: VA VA |
$121.63
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$660.04
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$462.03 |
| Max. Negotiated Rate |
$660.04 |
| Rate for Payer: Aetna Commercial |
$594.04
|
| Rate for Payer: ASR ASR |
$640.24
|
| Rate for Payer: BCBS Trust/PPO |
$511.73
|
| Rate for Payer: BCN Commercial |
$511.73
|
| Rate for Payer: Cash Price |
$528.03
|
| Rate for Payer: Cofinity Commercial |
$620.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.03
|
| Rate for Payer: Healthscope Commercial |
$660.04
|
| Rate for Payer: Healthscope Whirlpool |
$640.24
|
| Rate for Payer: Mclaren Commercial |
$594.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.84
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$129.03
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$90.32 |
| Max. Negotiated Rate |
$129.03 |
| Rate for Payer: Aetna Commercial |
$116.13
|
| Rate for Payer: ASR ASR |
$125.16
|
| Rate for Payer: BCBS Trust/PPO |
$100.04
|
| Rate for Payer: BCN Commercial |
$100.04
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Healthscope Commercial |
$129.03
|
| Rate for Payer: Healthscope Whirlpool |
$125.16
|
| Rate for Payer: Mclaren Commercial |
$116.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.55
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$129.03
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$129.03 |
| Rate for Payer: Aetna Commercial |
$116.13
|
| Rate for Payer: ASR ASR |
$125.16
|
| Rate for Payer: BCBS Complete |
$51.61
|
| Rate for Payer: BCBS Trust/PPO |
$100.04
|
| Rate for Payer: BCN Commercial |
$100.04
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Healthscope Commercial |
$129.03
|
| Rate for Payer: Healthscope Whirlpool |
$125.16
|
| Rate for Payer: Mclaren Commercial |
$116.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.99
|
| Rate for Payer: Priority Health Narrow Network |
$62.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.55
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$87.23 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| 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 |
$46.50
|
| Rate for Payer: BCBS Complete |
$11.95
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$37.17
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| 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 |
$40.75
|
| 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 |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.23
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$69.78
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$21.43
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.56 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| Rate for Payer: ASR ASR |
$46.50
|
| Rate for Payer: BCBS Trust/PPO |
$37.17
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$60.54 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| 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 |
$43.53
|
| Rate for Payer: BCBS Complete |
$11.95
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| 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 |
$38.15
|
| 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 |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.54
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$48.43
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$21.43
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
OP
|
$40.39
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$87.23 |
| Rate for Payer: Aetna Commercial |
$36.35
|
| 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 |
$39.18
|
| Rate for Payer: BCBS Complete |
$11.95
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$31.31
|
| Rate for Payer: BCN Commercial |
$31.31
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cofinity Commercial |
$37.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Healthscope Whirlpool |
$39.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$36.35
|
| 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 |
$34.33
|
| 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 |
$28.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.23
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$69.78
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.54
|
| Rate for Payer: UHC Medicare Advantage |
$21.43
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
IP
|
$40.39
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.27 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$36.35
|
| Rate for Payer: ASR ASR |
$39.18
|
| Rate for Payer: BCBS Trust/PPO |
$31.31
|
| Rate for Payer: BCN Commercial |
$31.31
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cofinity Commercial |
$37.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.31
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Healthscope Whirlpool |
$39.18
|
| Rate for Payer: Mclaren Commercial |
$36.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.54
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CANNABINOID URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$92.68 |
| Rate for Payer: Aetna Commercial |
$83.41
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$89.90
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.85
|
| Rate for Payer: BCN Commercial |
$71.85
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$87.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$92.68
|
| Rate for Payer: Healthscope Whirlpool |
$89.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$83.41
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.34
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$65.80
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.56
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC CANNABINOID URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.88 |
| Max. Negotiated Rate |
$92.68 |
| Rate for Payer: Aetna Commercial |
$83.41
|
| Rate for Payer: ASR ASR |
$89.90
|
| Rate for Payer: BCBS Trust/PPO |
$71.85
|
| Rate for Payer: BCN Commercial |
$71.85
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$87.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$92.68
|
| Rate for Payer: Healthscope Whirlpool |
$89.90
|
| Rate for Payer: Mclaren Commercial |
$83.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.56
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
IP
|
$867.00
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$606.90 |
| Max. Negotiated Rate |
$867.00 |
| Rate for Payer: Aetna Commercial |
$780.30
|
| Rate for Payer: ASR ASR |
$840.99
|
| Rate for Payer: BCBS Trust/PPO |
$672.19
|
| Rate for Payer: BCN Commercial |
$672.19
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$814.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.60
|
| Rate for Payer: Healthscope Commercial |
$867.00
|
| Rate for Payer: Healthscope Whirlpool |
$840.99
|
| Rate for Payer: Mclaren Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$762.96
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$867.00
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$346.80 |
| Max. Negotiated Rate |
$867.00 |
| Rate for Payer: Aetna Commercial |
$780.30
|
| Rate for Payer: ASR ASR |
$840.99
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS Trust/PPO |
$672.19
|
| Rate for Payer: BCN Commercial |
$672.19
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$814.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.60
|
| Rate for Payer: Healthscope Commercial |
$867.00
|
| Rate for Payer: Healthscope Whirlpool |
$840.99
|
| Rate for Payer: Mclaren Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.97
|
| Rate for Payer: Priority Health Narrow Network |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$762.96
|
|
