|
HC ALMONDS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC ALMONDS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| 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 Commercial |
$24.35
|
| 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 |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| 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 |
$21.24
|
| 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 |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| 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/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
IP
|
$50.40
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Aetna Commercial |
$45.36
|
| Rate for Payer: ASR ASR |
$48.89
|
| Rate for Payer: BCBS Trust/PPO |
$41.39
|
| Rate for Payer: BCN Commercial |
$41.39
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Commercial |
$47.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$48.89
|
| Rate for Payer: Healthscope Whirlpool |
$50.40
|
| Rate for Payer: Mclaren Commercial |
$45.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Nomi Health Commercial |
$41.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.35
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
OP
|
$50.40
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Aetna Commercial |
$45.36
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: ASR ASR |
$48.89
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS Trust/PPO |
$41.55
|
| Rate for Payer: BCN Commercial |
$41.55
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Commercial |
$47.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$48.89
|
| Rate for Payer: Healthscope Whirlpool |
$50.40
|
| Rate for Payer: Mclaren Commercial |
$45.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Nomi Health Commercial |
$41.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.16
|
| Rate for Payer: Priority Health Narrow Network |
$35.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.35
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
IP
|
$17.12
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$17.12 |
| Rate for Payer: Aetna Commercial |
$15.41
|
| Rate for Payer: ASR ASR |
$16.61
|
| Rate for Payer: BCBS Trust/PPO |
$14.06
|
| Rate for Payer: BCN Commercial |
$14.06
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cofinity Commercial |
$16.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: Healthscope Whirlpool |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.55
|
| Rate for Payer: Nomi Health Commercial |
$14.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.07
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
OP
|
$17.12
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$17.12 |
| Rate for Payer: Aetna Commercial |
$15.41
|
| Rate for Payer: Aetna Medicare |
$6.33
|
| Rate for Payer: ASR ASR |
$16.61
|
| Rate for Payer: BCBS Complete |
$6.85
|
| Rate for Payer: BCBS Trust/PPO |
$14.12
|
| Rate for Payer: BCN Commercial |
$14.12
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cofinity Commercial |
$16.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: Healthscope Whirlpool |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$15.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.55
|
| Rate for Payer: Nomi Health Commercial |
$14.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15.00
|
| Rate for Payer: Priority Health Narrow Network |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.07
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
IP
|
$43.16
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$32.37 |
| Max. Negotiated Rate |
$43.16 |
| Rate for Payer: Aetna Commercial |
$38.84
|
| Rate for Payer: ASR ASR |
$41.87
|
| Rate for Payer: BCBS Trust/PPO |
$35.44
|
| Rate for Payer: BCN Commercial |
$35.44
|
| Rate for Payer: Cash Price |
$34.53
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.53
|
| Rate for Payer: Healthscope Commercial |
$41.87
|
| Rate for Payer: Healthscope Whirlpool |
$43.16
|
| Rate for Payer: Mclaren Commercial |
$38.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.69
|
| Rate for Payer: Nomi Health Commercial |
$35.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.98
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
OP
|
$43.16
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$15.97 |
| Max. Negotiated Rate |
$43.16 |
| Rate for Payer: Aetna Commercial |
$38.84
|
| Rate for Payer: Aetna Medicare |
$15.97
|
| Rate for Payer: ASR ASR |
$41.87
|
| Rate for Payer: BCBS Complete |
$17.26
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$34.53
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.53
|
| Rate for Payer: Healthscope Commercial |
$41.87
|
| Rate for Payer: Healthscope Whirlpool |
$43.16
|
| Rate for Payer: Mclaren Commercial |
$38.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.69
|
| Rate for Payer: Nomi Health Commercial |
$35.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.82
|
| Rate for Payer: Priority Health Narrow Network |
$30.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.98
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
OP
|
$60.34
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$60.34 |
| Rate for Payer: Aetna Commercial |
$54.31
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.07
|
| Rate for Payer: ASR ASR |
$58.53
|
| Rate for Payer: BCBS Complete |
$7.94
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$49.75
|
| Rate for Payer: BCN Commercial |
$49.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$56.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Whirlpool |
$60.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.46
|
| Rate for Payer: Mclaren Commercial |
$54.31
|
| Rate for Payer: Mclaren Medicaid |
$14.46
|
| Rate for Payer: Mclaren Medicare |
$14.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: Meridian Medicaid |
$7.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: PACE Medicare |
$13.74
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$15.91
|
| Rate for Payer: PHP Medicaid |
$7.75
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.87
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow Network |
$42.30
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.46
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicaid |
$7.56
|
| Rate for Payer: UHCCP DNSP |
$14.46
|
| Rate for Payer: UHCCP Medicaid |
$7.56
|
| Rate for Payer: VA VA |
$14.46
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
IP
|
$60.34
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.26 |
| Max. Negotiated Rate |
$60.34 |
| Rate for Payer: Aetna Commercial |
$54.31
|
| Rate for Payer: ASR ASR |
$58.53
|
| Rate for Payer: BCBS Trust/PPO |
$49.55
|
| Rate for Payer: BCN Commercial |
$49.55
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$56.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Whirlpool |
$60.34
|
| Rate for Payer: Mclaren Commercial |
$54.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.10
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
IP
|
$44.57
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$44.57 |
| Rate for Payer: Aetna Commercial |
$40.11
|
| Rate for Payer: ASR ASR |
$43.23
|
| Rate for Payer: BCBS Trust/PPO |
$36.60
|
| Rate for Payer: BCN Commercial |
$36.60
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.66
|
| Rate for Payer: Healthscope Commercial |
$43.23
|
| Rate for Payer: Healthscope Whirlpool |
$44.57
|
| Rate for Payer: Mclaren Commercial |
$40.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.88
|
| Rate for Payer: Nomi Health Commercial |
$36.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.22
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
OP
|
$44.57
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$129.53 |
| Rate for Payer: Aetna Commercial |
$40.11
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$43.23
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$36.75
|
| Rate for Payer: BCN Commercial |
$36.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$43.23
|
| Rate for Payer: Healthscope Whirlpool |
$44.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$40.11
|
| Rate for Payer: Mclaren Medicaid |
$13.44
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.88
|
| Rate for Payer: Nomi Health Commercial |
$36.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.43
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$129.53
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$103.62
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$37.14 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Trust/PPO |
$30.50
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$129.53 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$30.62
|
| Rate for Payer: BCN Commercial |
$30.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$13.44
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$129.53
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$103.62
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$129.53 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$13.44
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$129.53
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$103.62
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
IP
|
$59.82
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.87 |
| Max. Negotiated Rate |
$59.82 |
| Rate for Payer: Aetna Commercial |
$53.84
|
| Rate for Payer: ASR ASR |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$49.12
|
| Rate for Payer: BCN Commercial |
$49.12
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$56.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$58.03
|
| Rate for Payer: Healthscope Whirlpool |
$59.82
|
| Rate for Payer: Mclaren Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.64
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
OP
|
$59.82
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$59.82 |
| Rate for Payer: Aetna Commercial |
$53.84
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.07
|
| Rate for Payer: ASR ASR |
$58.03
|
| Rate for Payer: BCBS Complete |
$7.94
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$49.32
|
| Rate for Payer: BCN Commercial |
$49.32
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$56.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$58.03
|
| Rate for Payer: Healthscope Whirlpool |
$59.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.46
|
| Rate for Payer: Mclaren Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$14.46
|
| Rate for Payer: Mclaren Medicare |
$14.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: Meridian Medicaid |
$7.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: PACE Medicare |
$13.74
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$15.91
|
| Rate for Payer: PHP Medicaid |
$7.75
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.41
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow Network |
$41.93
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.46
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicaid |
$7.56
|
| Rate for Payer: UHCCP DNSP |
$14.46
|
| Rate for Payer: UHCCP Medicaid |
$7.56
|
| Rate for Payer: VA VA |
$14.46
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
OP
|
$176.87
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$159.18
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$171.56
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$145.83
|
| Rate for Payer: BCN Commercial |
$145.83
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$166.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$171.56
|
| Rate for Payer: Healthscope Whirlpool |
$176.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$159.18
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.65
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
IP
|
$176.87
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$132.65 |
| Max. Negotiated Rate |
$176.87 |
| Rate for Payer: Aetna Commercial |
$159.18
|
| Rate for Payer: ASR ASR |
$171.56
|
| Rate for Payer: BCBS Trust/PPO |
$145.25
|
| Rate for Payer: BCN Commercial |
$145.25
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$166.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Healthscope Commercial |
$171.56
|
| Rate for Payer: Healthscope Whirlpool |
$176.87
|
| Rate for Payer: Mclaren Commercial |
$159.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.65
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
OP
|
$76.05
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$76.05 |
| Rate for Payer: Aetna Commercial |
$68.44
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.25
|
| Rate for Payer: ASR ASR |
$73.77
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$62.70
|
| Rate for Payer: BCN Commercial |
$62.70
|
| Rate for Payer: BCN Medicare Advantage |
$17.00
|
| Rate for Payer: Cash Price |
$60.84
|
| Rate for Payer: Cash Price |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$71.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$73.77
|
| Rate for Payer: Healthscope Whirlpool |
$76.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.00
|
| Rate for Payer: Mclaren Commercial |
$68.44
|
| Rate for Payer: Mclaren Medicaid |
$17.00
|
| Rate for Payer: Mclaren Medicare |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.85
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.64
|
| Rate for Payer: Nomi Health Commercial |
$62.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.04
|
| Rate for Payer: PACE Medicare |
$16.15
|
| Rate for Payer: PACE SWMI |
$17.00
|
| Rate for Payer: PHP Commercial |
$18.70
|
| Rate for Payer: PHP Medicaid |
$9.11
|
| Rate for Payer: PHP Medicare Advantage |
$17.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.64
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow Network |
$53.31
|
| Rate for Payer: Railroad Medicare Medicare |
$17.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.00
|
| Rate for Payer: UHC Exchange |
$26.35
|
| Rate for Payer: UHC Medicaid |
$8.89
|
| Rate for Payer: UHCCP DNSP |
$17.00
|
| Rate for Payer: UHCCP Medicaid |
$8.89
|
| Rate for Payer: VA VA |
$17.00
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
IP
|
$76.05
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$57.04 |
| Max. Negotiated Rate |
$76.05 |
| Rate for Payer: Aetna Commercial |
$68.44
|
| Rate for Payer: ASR ASR |
$73.77
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$62.45
|
| Rate for Payer: Cash Price |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$71.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.84
|
| Rate for Payer: Healthscope Commercial |
$73.77
|
| Rate for Payer: Healthscope Whirlpool |
$76.05
|
| Rate for Payer: Mclaren Commercial |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.64
|
| Rate for Payer: Nomi Health Commercial |
$62.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.92
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$124.68 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.96
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Complete |
$9.21
|
| Rate for Payer: BCBS MAPPO |
$16.77
|
| Rate for Payer: BCBS Trust/PPO |
$30.62
|
| Rate for Payer: BCN Commercial |
$30.62
|
| Rate for Payer: BCN Medicare Advantage |
$16.77
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.77
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.77
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$16.77
|
| Rate for Payer: Mclaren Medicare |
$16.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.61
|
| Rate for Payer: Meridian Medicaid |
$9.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Medicare |
$15.93
|
| Rate for Payer: PACE SWMI |
$16.77
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicaid |
$8.99
|
| Rate for Payer: PHP Medicare Advantage |
$16.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.68
|
| Rate for Payer: Priority Health Medicare |
$16.77
|
| Rate for Payer: Priority Health Narrow Network |
$99.74
|
| Rate for Payer: Railroad Medicare Medicare |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.77
|
| Rate for Payer: UHC Exchange |
$25.99
|
| Rate for Payer: UHC Medicaid |
$8.77
|
| Rate for Payer: UHCCP DNSP |
$16.77
|
| Rate for Payer: UHCCP Medicaid |
$8.77
|
| Rate for Payer: VA VA |
$16.77
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$37.14 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Trust/PPO |
$30.50
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
|
|
HC ALPHA FETOPROTEIN TUMOR MARKER
|
Facility
|
IP
|
$65.79
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.34 |
| Max. Negotiated Rate |
$65.79 |
| Rate for Payer: Aetna Commercial |
$59.21
|
| Rate for Payer: ASR ASR |
$63.82
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$54.03
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$61.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$63.82
|
| Rate for Payer: Healthscope Whirlpool |
$65.79
|
| Rate for Payer: Mclaren Commercial |
$59.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Nomi Health Commercial |
$53.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.90
|
|
