|
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
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
OP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$52.05
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$56.10
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$47.68
|
| Rate for Payer: BCN Commercial |
$47.68
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$54.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$57.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$52.05
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
IP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.37 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna Commercial |
$52.05
|
| Rate for Payer: ASR ASR |
$56.10
|
| Rate for Payer: BCBS Trust/PPO |
$47.49
|
| Rate for Payer: BCN Commercial |
$47.49
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$54.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$57.83
|
| Rate for Payer: Mclaren Commercial |
$52.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.89
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
OP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$52.05
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$56.10
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$47.68
|
| Rate for Payer: BCN Commercial |
$47.68
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$54.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$57.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$52.05
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
IP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.37 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna Commercial |
$52.05
|
| Rate for Payer: ASR ASR |
$56.10
|
| Rate for Payer: BCBS Trust/PPO |
$47.49
|
| Rate for Payer: BCN Commercial |
$47.49
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$54.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$57.83
|
| Rate for Payer: Mclaren Commercial |
$52.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.89
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
OP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$182.14 |
| Rate for Payer: Aetna Commercial |
$163.93
|
| Rate for Payer: Aetna Medicare |
$67.39
|
| Rate for Payer: ASR ASR |
$176.68
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS Trust/PPO |
$150.17
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$150.17
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$171.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Healthscope Commercial |
$176.68
|
| Rate for Payer: Healthscope Whirlpool |
$182.14
|
| Rate for Payer: Mclaren Commercial |
$163.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$149.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.28
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
IP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$136.60 |
| Max. Negotiated Rate |
$182.14 |
| Rate for Payer: Aetna Commercial |
$163.93
|
| Rate for Payer: ASR ASR |
$176.68
|
| Rate for Payer: BCBS Trust/PPO |
$149.57
|
| Rate for Payer: BCN Commercial |
$149.57
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$171.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Healthscope Commercial |
$176.68
|
| Rate for Payer: Healthscope Whirlpool |
$182.14
|
| Rate for Payer: Mclaren Commercial |
$163.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$149.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.28
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.13 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Trust/PPO |
$59.27
|
| Rate for Payer: BCN Commercial |
$59.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$33.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.42
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Complete |
$18.64
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCBS Trust/PPO |
$59.50
|
| Rate for Payer: BCN Commercial |
$59.50
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.94
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Mclaren Medicaid |
$33.94
|
| Rate for Payer: Mclaren Medicare |
$33.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Meridian Medicaid |
$18.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Medicare |
$32.24
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Commercial |
$37.33
|
| Rate for Payer: PHP Medicaid |
$18.19
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63.24
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health Narrow Network |
$50.59
|
| Rate for Payer: Railroad Medicare Medicare |
$33.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.94
|
| Rate for Payer: UHC Exchange |
$52.61
|
| Rate for Payer: UHC Medicaid |
$17.75
|
| Rate for Payer: UHCCP DNSP |
$33.94
|
| Rate for Payer: UHCCP Medicaid |
$17.75
|
| Rate for Payer: VA VA |
$33.94
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
IP
|
$75.35
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$75.35 |
| Rate for Payer: Aetna Commercial |
$67.81
|
| Rate for Payer: ASR ASR |
$73.09
|
| Rate for Payer: BCBS Trust/PPO |
$61.88
|
| Rate for Payer: BCN Commercial |
$61.88
|
| Rate for Payer: Cash Price |
$60.28
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.28
|
| Rate for Payer: Healthscope Commercial |
$73.09
|
| Rate for Payer: Healthscope Whirlpool |
$75.35
|
| Rate for Payer: Mclaren Commercial |
$67.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.05
|
| Rate for Payer: Nomi Health Commercial |
$61.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.31
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
OP
|
$75.35
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.88 |
| Max. Negotiated Rate |
$75.35 |
| Rate for Payer: Aetna Commercial |
$67.81
|
| Rate for Payer: Aetna Medicare |
$27.88
|
| Rate for Payer: ASR ASR |
$73.09
|
| Rate for Payer: BCBS Complete |
$30.14
|
| Rate for Payer: BCBS Trust/PPO |
$62.13
|
| Rate for Payer: BCN Commercial |
$62.13
|
| Rate for Payer: Cash Price |
$60.28
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.28
|
| Rate for Payer: Healthscope Commercial |
$73.09
|
| Rate for Payer: Healthscope Whirlpool |
$75.35
|
| Rate for Payer: Mclaren Commercial |
$67.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.05
|
| Rate for Payer: Nomi Health Commercial |
$61.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.02
|
| Rate for Payer: Priority Health Narrow Network |
$52.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.31
|
|
|
HC ANTI FACTOR XA
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.69 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.36
|
| Rate for Payer: BCN Commercial |
$65.36
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
|
|
HC ANTI FACTOR XA
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$13.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$65.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.09
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$13.09
|
| Rate for Payer: Mclaren Medicare |
$13.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$7.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$14.40
|
| Rate for Payer: PHP Medicaid |
$7.02
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.74
|
| Rate for Payer: Priority Health Medicare |
$13.09
|
| Rate for Payer: Priority Health Narrow Network |
$55.79
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.09
|
| Rate for Payer: UHC Exchange |
$20.29
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP DNSP |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$13.09
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$104.49
|
| Rate for Payer: ASR ASR |
$112.62
|
| Rate for Payer: BCBS Trust/PPO |
$95.34
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$112.62
|
| Rate for Payer: Healthscope Whirlpool |
$116.10
|
| Rate for Payer: Mclaren Commercial |
$104.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.17
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$104.49
|
| Rate for Payer: Aetna Medicare |
$3.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.79
|
| Rate for Payer: ASR ASR |
$112.62
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: BCBS MAPPO |
$3.83
|
| Rate for Payer: BCBS Trust/PPO |
$95.72
|
| Rate for Payer: BCN Commercial |
$95.72
|
| Rate for Payer: BCN Medicare Advantage |
$3.83
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.83
|
| Rate for Payer: Healthscope Commercial |
$112.62
|
| Rate for Payer: Healthscope Whirlpool |
$116.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.83
|
| Rate for Payer: Mclaren Commercial |
$104.49
|
| Rate for Payer: Mclaren Medicaid |
$3.83
|
| Rate for Payer: Mclaren Medicare |
$3.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: Meridian Medicaid |
$2.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Medicare |
$3.64
|
| Rate for Payer: PACE SWMI |
$3.83
|
| Rate for Payer: PHP Commercial |
$4.21
|
| Rate for Payer: PHP Medicaid |
$2.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.73
|
| Rate for Payer: Priority Health Medicare |
$3.83
|
| Rate for Payer: Priority Health Narrow Network |
$81.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.83
|
| Rate for Payer: UHC Exchange |
$5.94
|
| Rate for Payer: UHC Medicaid |
$2.00
|
| Rate for Payer: UHCCP DNSP |
$3.83
|
| Rate for Payer: UHCCP Medicaid |
$2.00
|
| Rate for Payer: VA VA |
$3.83
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$104.49
|
| Rate for Payer: Aetna Medicare |
$6.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.94
|
| Rate for Payer: ASR ASR |
$112.62
|
| Rate for Payer: BCBS Complete |
$3.49
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$95.72
|
| Rate for Payer: BCN Commercial |
$95.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$112.62
|
| Rate for Payer: Healthscope Whirlpool |
$116.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.35
|
| Rate for Payer: Mclaren Commercial |
$104.49
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Mclaren Medicare |
$6.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Medicaid |
$3.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Medicare |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$6.99
|
| Rate for Payer: PHP Medicaid |
$3.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.73
|
| Rate for Payer: Priority Health Medicare |
$6.35
|
| Rate for Payer: Priority Health Narrow Network |
$81.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.35
|
| Rate for Payer: UHC Exchange |
$9.84
|
| Rate for Payer: UHC Medicaid |
$3.32
|
| Rate for Payer: UHCCP DNSP |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.32
|
| Rate for Payer: VA VA |
$6.35
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$104.49
|
| Rate for Payer: ASR ASR |
$112.62
|
| Rate for Payer: BCBS Trust/PPO |
$95.34
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$112.62
|
| Rate for Payer: Healthscope Whirlpool |
$116.10
|
| Rate for Payer: Mclaren Commercial |
$104.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.17
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$104.49
|
| Rate for Payer: Aetna Medicare |
$6.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.94
|
| Rate for Payer: ASR ASR |
$112.62
|
| Rate for Payer: BCBS Complete |
$3.49
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$95.72
|
| Rate for Payer: BCN Commercial |
$95.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$112.62
|
| Rate for Payer: Healthscope Whirlpool |
$116.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.35
|
| Rate for Payer: Mclaren Commercial |
$104.49
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Mclaren Medicare |
$6.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Medicaid |
$3.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Medicare |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$6.99
|
| Rate for Payer: PHP Medicaid |
$3.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.73
|
| Rate for Payer: Priority Health Medicare |
$6.35
|
| Rate for Payer: Priority Health Narrow Network |
$81.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.35
|
| Rate for Payer: UHC Exchange |
$9.84
|
| Rate for Payer: UHC Medicaid |
$3.32
|
| Rate for Payer: UHCCP DNSP |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.32
|
| Rate for Payer: VA VA |
$6.35
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Aetna Commercial |
$104.49
|
| Rate for Payer: ASR ASR |
$112.62
|
| Rate for Payer: BCBS Trust/PPO |
$95.34
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$112.62
|
| Rate for Payer: Healthscope Whirlpool |
$116.10
|
| Rate for Payer: Mclaren Commercial |
$104.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.17
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$58.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$345.01 |
| Rate for Payer: Aetna Commercial |
$52.52
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$56.61
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$48.12
|
| Rate for Payer: BCN Commercial |
$48.12
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$54.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$56.61
|
| Rate for Payer: Healthscope Whirlpool |
$58.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$52.52
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$345.01
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$276.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$58.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$58.36 |
| Rate for Payer: Aetna Commercial |
$52.52
|
| Rate for Payer: ASR ASR |
$56.61
|
| Rate for Payer: BCBS Trust/PPO |
$47.93
|
| Rate for Payer: BCN Commercial |
$47.93
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$54.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$56.61
|
| Rate for Payer: Healthscope Whirlpool |
$58.36
|
| Rate for Payer: Mclaren Commercial |
$52.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.36
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$34.38
|
| 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 |
$37.05
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$31.50
|
| Rate for Payer: BCN Commercial |
$31.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$37.05
|
| Rate for Payer: Healthscope Whirlpool |
$38.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$34.38
|
| 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 |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| 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 |
$33.62
|
| 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 ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.65 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$34.38
|
| Rate for Payer: ASR ASR |
$37.05
|
| Rate for Payer: BCBS Trust/PPO |
$31.37
|
| Rate for Payer: BCN Commercial |
$31.37
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$37.05
|
| Rate for Payer: Healthscope Whirlpool |
$38.20
|
| Rate for Payer: Mclaren Commercial |
$34.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.62
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$125.89
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$125.89 |
| Rate for Payer: Aetna Commercial |
$113.30
|
| Rate for Payer: Aetna Medicare |
$38.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.27
|
| Rate for Payer: ASR ASR |
$122.11
|
| Rate for Payer: BCBS Complete |
$21.21
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$103.80
|
| Rate for Payer: BCN Commercial |
$103.80
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cofinity Commercial |
$118.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$122.11
|
| Rate for Payer: Healthscope Whirlpool |
$125.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.62
|
| Rate for Payer: Mclaren Commercial |
$113.30
|
| Rate for Payer: Mclaren Medicaid |
$38.62
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$21.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.01
|
| Rate for Payer: Nomi Health Commercial |
$103.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.42
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicaid |
$20.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$110.30
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health Narrow Network |
$88.25
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.62
|
| Rate for Payer: UHC Exchange |
$59.86
|
| Rate for Payer: UHC Medicaid |
$20.20
|
| Rate for Payer: UHCCP DNSP |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$20.20
|
| Rate for Payer: VA VA |
$38.62
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$125.89
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.42 |
| Max. Negotiated Rate |
$125.89 |
| Rate for Payer: Aetna Commercial |
$113.30
|
| Rate for Payer: ASR ASR |
$122.11
|
| Rate for Payer: BCBS Trust/PPO |
$103.38
|
| Rate for Payer: BCN Commercial |
$103.38
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cofinity Commercial |
$118.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.71
|
| Rate for Payer: Healthscope Commercial |
$122.11
|
| Rate for Payer: Healthscope Whirlpool |
$125.89
|
| Rate for Payer: Mclaren Commercial |
$113.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.01
|
| Rate for Payer: Nomi Health Commercial |
$103.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.78
|
|
