|
HC ANTIBODY ABSORPTION
|
Facility
|
OP
|
$120.17
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$120.17 |
| Rate for Payer: Aetna Commercial |
$108.15
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$116.56
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$99.08
|
| Rate for Payer: BCN Commercial |
$99.08
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cofinity Commercial |
$112.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$116.56
|
| Rate for Payer: Healthscope Whirlpool |
$120.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$108.15
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.14
|
| Rate for Payer: Nomi Health Commercial |
$98.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.13
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$60.53
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$48.43
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
IP
|
$120.17
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$90.13 |
| Max. Negotiated Rate |
$120.17 |
| Rate for Payer: Aetna Commercial |
$108.15
|
| Rate for Payer: ASR ASR |
$116.56
|
| Rate for Payer: BCBS Trust/PPO |
$98.68
|
| Rate for Payer: BCN Commercial |
$98.68
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cofinity Commercial |
$112.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.14
|
| Rate for Payer: Healthscope Commercial |
$116.56
|
| Rate for Payer: Healthscope Whirlpool |
$120.17
|
| Rate for Payer: Mclaren Commercial |
$108.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.14
|
| Rate for Payer: Nomi Health Commercial |
$98.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.75
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.43
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$17.50
|
| Rate for Payer: BCN Commercial |
$17.50
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$13.03
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.60
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.03
|
| Rate for Payer: UHC Exchange |
$20.20
|
| Rate for Payer: UHC Medicaid |
$6.81
|
| Rate for Payer: UHCCP DNSP |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$6.81
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$17.50
|
| Rate for Payer: BCN Commercial |
$17.50
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$13.03
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.60
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.03
|
| Rate for Payer: UHC Exchange |
$20.20
|
| Rate for Payer: UHC Medicaid |
$6.81
|
| Rate for Payer: UHCCP DNSP |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$6.81
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.43
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.51 |
| Max. Negotiated Rate |
$23.35 |
| Rate for Payer: Aetna Commercial |
$21.02
|
| Rate for Payer: ASR ASR |
$22.65
|
| Rate for Payer: BCBS Trust/PPO |
$19.18
|
| Rate for Payer: BCN Commercial |
$19.18
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Healthscope Whirlpool |
$23.35
|
| Rate for Payer: Mclaren Commercial |
$21.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.55
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$23.35 |
| Rate for Payer: Aetna Commercial |
$21.02
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$22.65
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$19.25
|
| Rate for Payer: BCN Commercial |
$19.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Healthscope Whirlpool |
$23.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$21.02
|
| Rate for Payer: Mclaren Medicaid |
$13.03
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.46
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$16.37
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.03
|
| Rate for Payer: UHC Exchange |
$20.20
|
| Rate for Payer: UHC Medicaid |
$6.81
|
| Rate for Payer: UHCCP DNSP |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$6.81
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.51 |
| Max. Negotiated Rate |
$23.35 |
| Rate for Payer: Aetna Commercial |
$21.02
|
| Rate for Payer: ASR ASR |
$22.65
|
| Rate for Payer: BCBS Trust/PPO |
$19.18
|
| Rate for Payer: BCN Commercial |
$19.18
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Healthscope Whirlpool |
$23.35
|
| Rate for Payer: Mclaren Commercial |
$21.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.55
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$23.35 |
| Rate for Payer: Aetna Commercial |
$21.02
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$22.65
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$19.25
|
| Rate for Payer: BCN Commercial |
$19.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Healthscope Whirlpool |
$23.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$21.02
|
| Rate for Payer: Mclaren Medicaid |
$13.03
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.46
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$16.37
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.03
|
| Rate for Payer: UHC Exchange |
$20.20
|
| Rate for Payer: UHC Medicaid |
$6.81
|
| Rate for Payer: UHCCP DNSP |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$6.81
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
OP
|
$305.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$88.78 |
| Max. Negotiated Rate |
$305.78 |
| Rate for Payer: Aetna Commercial |
$275.20
|
| Rate for Payer: Aetna Medicare |
$169.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: ASR ASR |
$296.61
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$252.12
|
| Rate for Payer: BCN Commercial |
$252.12
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$244.62
|
| Rate for Payer: Cash Price |
$244.62
|
| Rate for Payer: Cofinity Commercial |
$287.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$296.61
|
| Rate for Payer: Healthscope Whirlpool |
$305.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$169.76
|
| Rate for Payer: Mclaren Commercial |
$275.20
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$93.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.91
|
| Rate for Payer: Nomi Health Commercial |
$250.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.34
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$186.74
|
| Rate for Payer: PHP Medicaid |
$90.99
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$267.92
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health Narrow Network |
$214.35
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$263.13
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP DNSP |
$169.76
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: VA VA |
$169.76
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
IP
|
$305.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$229.34 |
| Max. Negotiated Rate |
$305.78 |
| Rate for Payer: Aetna Commercial |
$275.20
|
| Rate for Payer: ASR ASR |
$296.61
|
| Rate for Payer: BCBS Trust/PPO |
$251.11
|
| Rate for Payer: BCN Commercial |
$251.11
|
| Rate for Payer: Cash Price |
$244.62
|
| Rate for Payer: Cofinity Commercial |
$287.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.62
|
| Rate for Payer: Healthscope Commercial |
$296.61
|
| Rate for Payer: Healthscope Whirlpool |
$305.78
|
| Rate for Payer: Mclaren Commercial |
$275.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.91
|
| Rate for Payer: Nomi Health Commercial |
$250.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.09
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$217.55
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.09 |
| Max. Negotiated Rate |
$553.60 |
| Rate for Payer: Aetna Commercial |
$195.79
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$211.02
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$179.37
|
| Rate for Payer: BCN Commercial |
$179.37
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$204.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$211.02
|
| Rate for Payer: Healthscope Whirlpool |
$217.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$195.79
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$150.11
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$120.09
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$217.55
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$163.16 |
| Max. Negotiated Rate |
$217.55 |
| Rate for Payer: Aetna Commercial |
$195.79
|
| Rate for Payer: ASR ASR |
$211.02
|
| Rate for Payer: BCBS Trust/PPO |
$178.65
|
| Rate for Payer: BCN Commercial |
$178.65
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$204.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$211.02
|
| Rate for Payer: Healthscope Whirlpool |
$217.55
|
| Rate for Payer: Mclaren Commercial |
$195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.44
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
IP
|
$95.72
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.79 |
| Max. Negotiated Rate |
$95.72 |
| Rate for Payer: Aetna Commercial |
$86.15
|
| Rate for Payer: ASR ASR |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$78.61
|
| Rate for Payer: BCN Commercial |
$78.61
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$89.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Healthscope Commercial |
$92.85
|
| Rate for Payer: Healthscope Whirlpool |
$95.72
|
| Rate for Payer: Mclaren Commercial |
$86.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.23
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
OP
|
$95.72
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$181.60 |
| Rate for Payer: Aetna Commercial |
$86.15
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$92.85
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$78.92
|
| Rate for Payer: BCN Commercial |
$78.92
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$89.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$92.85
|
| Rate for Payer: Healthscope Whirlpool |
$95.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$86.15
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.79
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.55
|
| Rate for Payer: PHP Medicaid |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$181.60
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$145.28
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.05
|
| Rate for Payer: UHC Exchange |
$23.33
|
| Rate for Payer: UHC Medicaid |
$7.87
|
| Rate for Payer: UHCCP DNSP |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$7.87
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.82 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Trust/PPO |
$39.22
|
| Rate for Payer: BCN Commercial |
$39.22
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$58.11 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare |
$17.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$39.38
|
| Rate for Payer: BCN Commercial |
$39.38
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.03
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Mclaren Medicare |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$9.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$18.73
|
| Rate for Payer: PHP Medicaid |
$9.13
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.11
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health Narrow Network |
$46.49
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.03
|
| Rate for Payer: UHC Exchange |
$26.40
|
| Rate for Payer: UHC Medicaid |
$8.91
|
| Rate for Payer: UHCCP DNSP |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$8.91
|
| Rate for Payer: VA VA |
$17.03
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
OP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$31.52
|
| Rate for Payer: Aetna Medicare |
$15.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.36
|
| Rate for Payer: ASR ASR |
$33.97
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS MAPPO |
$15.49
|
| Rate for Payer: BCBS Trust/PPO |
$28.87
|
| Rate for Payer: BCN Commercial |
$28.87
|
| Rate for Payer: BCN Medicare Advantage |
$15.49
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$32.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Healthscope Whirlpool |
$35.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.49
|
| Rate for Payer: Mclaren Commercial |
$31.52
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Mclaren Medicare |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$8.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$28.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.49
|
| Rate for Payer: PHP Commercial |
$17.04
|
| Rate for Payer: PHP Medicaid |
$8.30
|
| Rate for Payer: PHP Medicare Advantage |
$15.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.53
|
| Rate for Payer: Priority Health Medicare |
$15.49
|
| Rate for Payer: Priority Health Narrow Network |
$30.02
|
| Rate for Payer: Railroad Medicare Medicare |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.49
|
| Rate for Payer: UHC Exchange |
$24.01
|
| Rate for Payer: UHC Medicaid |
$8.10
|
| Rate for Payer: UHCCP DNSP |
$15.49
|
| Rate for Payer: UHCCP Medicaid |
$8.10
|
| Rate for Payer: VA VA |
$15.49
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
IP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.27 |
| Max. Negotiated Rate |
$35.02 |
| Rate for Payer: Aetna Commercial |
$31.52
|
| Rate for Payer: ASR ASR |
$33.97
|
| Rate for Payer: BCBS Trust/PPO |
$28.76
|
| Rate for Payer: BCN Commercial |
$28.76
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$32.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Healthscope Whirlpool |
$35.02
|
| Rate for Payer: Mclaren Commercial |
$31.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$28.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.82
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.94 |
| Max. Negotiated Rate |
$67.92 |
| Rate for Payer: Aetna Commercial |
$61.13
|
| Rate for Payer: ASR ASR |
$65.88
|
| Rate for Payer: BCBS Trust/PPO |
$55.78
|
| Rate for Payer: BCN Commercial |
$55.78
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$63.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$65.88
|
| Rate for Payer: Healthscope Whirlpool |
$67.92
|
| Rate for Payer: Mclaren Commercial |
$61.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.77
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$67.92 |
| Rate for Payer: Aetna Commercial |
$61.13
|
| Rate for Payer: Aetna Medicare |
$17.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: ASR ASR |
$65.88
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.00
|
| Rate for Payer: BCN Commercial |
$56.00
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$63.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$65.88
|
| Rate for Payer: Healthscope Whirlpool |
$67.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.03
|
| Rate for Payer: Mclaren Commercial |
$61.13
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Mclaren Medicare |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$9.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Medicare |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$18.73
|
| Rate for Payer: PHP Medicaid |
$9.13
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.11
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health Narrow Network |
$46.49
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.03
|
| Rate for Payer: UHC Exchange |
$26.40
|
| Rate for Payer: UHC Medicaid |
$8.91
|
| Rate for Payer: UHCCP DNSP |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$8.91
|
| Rate for Payer: VA VA |
$17.03
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
IP
|
$87.29
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.47 |
| Max. Negotiated Rate |
$87.29 |
| Rate for Payer: Aetna Commercial |
$78.56
|
| Rate for Payer: ASR ASR |
$84.67
|
| Rate for Payer: BCBS Trust/PPO |
$71.68
|
| Rate for Payer: BCN Commercial |
$71.68
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$82.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Healthscope Commercial |
$84.67
|
| Rate for Payer: Healthscope Whirlpool |
$87.29
|
| Rate for Payer: Mclaren Commercial |
$78.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.82
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
OP
|
$87.29
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.32 |
| Max. Negotiated Rate |
$87.29 |
| Rate for Payer: Aetna Commercial |
$78.56
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.89
|
| Rate for Payer: ASR ASR |
$84.67
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS MAPPO |
$15.91
|
| Rate for Payer: BCBS Trust/PPO |
$71.97
|
| Rate for Payer: BCN Commercial |
$71.97
|
| Rate for Payer: BCN Medicare Advantage |
$15.91
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$82.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.91
|
| Rate for Payer: Healthscope Commercial |
$84.67
|
| Rate for Payer: Healthscope Whirlpool |
$87.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.91
|
| Rate for Payer: Mclaren Commercial |
$78.56
|
| Rate for Payer: Mclaren Medicaid |
$15.91
|
| Rate for Payer: Mclaren Medicare |
$15.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$8.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PACE Medicare |
$15.11
|
| Rate for Payer: PACE SWMI |
$15.91
|
| Rate for Payer: PHP Commercial |
$17.50
|
| Rate for Payer: PHP Medicaid |
$8.53
|
| Rate for Payer: PHP Medicare Advantage |
$15.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.58
|
| Rate for Payer: Priority Health Medicare |
$15.91
|
| Rate for Payer: Priority Health Narrow Network |
$53.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.91
|
| Rate for Payer: UHC Exchange |
$24.66
|
| Rate for Payer: UHC Medicaid |
$8.32
|
| Rate for Payer: UHCCP DNSP |
$15.91
|
| Rate for Payer: UHCCP Medicaid |
$8.32
|
| Rate for Payer: VA VA |
$15.91
|
|
|
HC ANTIBODY TITER
|
Facility
|
IP
|
$277.37
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$208.03 |
| Max. Negotiated Rate |
$277.37 |
| Rate for Payer: Aetna Commercial |
$249.63
|
| Rate for Payer: ASR ASR |
$269.05
|
| Rate for Payer: BCBS Trust/PPO |
$227.78
|
| Rate for Payer: BCN Commercial |
$227.78
|
| Rate for Payer: Cash Price |
$221.90
|
| Rate for Payer: Cofinity Commercial |
$260.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.90
|
| Rate for Payer: Healthscope Commercial |
$269.05
|
| Rate for Payer: Healthscope Whirlpool |
$277.37
|
| Rate for Payer: Mclaren Commercial |
$249.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.76
|
| Rate for Payer: Nomi Health Commercial |
$227.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.09
|
|
