|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$73.54
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna Medicare |
$13.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: ASR ASR |
$71.33
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$60.63
|
| Rate for Payer: BCN Commercial |
$60.63
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$69.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$71.33
|
| Rate for Payer: Healthscope Whirlpool |
$73.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.74
|
| Rate for Payer: Mclaren Commercial |
$66.19
|
| Rate for Payer: Mclaren Medicaid |
$13.74
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$7.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$15.11
|
| Rate for Payer: PHP Medicaid |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39.95
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health Narrow Network |
$31.96
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.74
|
| Rate for Payer: UHC Exchange |
$21.30
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHCCP DNSP |
$13.74
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$13.74
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$73.54
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.16 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: ASR ASR |
$71.33
|
| Rate for Payer: BCBS Trust/PPO |
$60.39
|
| Rate for Payer: BCN Commercial |
$60.39
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$69.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Healthscope Commercial |
$71.33
|
| Rate for Payer: Healthscope Whirlpool |
$73.54
|
| Rate for Payer: Mclaren Commercial |
$66.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.72
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$73.54
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.16 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: ASR ASR |
$71.33
|
| Rate for Payer: BCBS Trust/PPO |
$60.39
|
| Rate for Payer: BCN Commercial |
$60.39
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$69.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Healthscope Commercial |
$71.33
|
| Rate for Payer: Healthscope Whirlpool |
$73.54
|
| Rate for Payer: Mclaren Commercial |
$66.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.72
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$73.54
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$71.33
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$60.63
|
| Rate for Payer: BCN Commercial |
$60.63
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$69.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$71.33
|
| Rate for Payer: Healthscope Whirlpool |
$73.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$66.19
|
| Rate for Payer: Mclaren Medicaid |
$12.09
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$32.93
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.74
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHCCP DNSP |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
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 ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.38
|
| Rate for Payer: BCN Commercial |
$39.38
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| 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 |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$12.09
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.30
|
| 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 |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$32.93
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.74
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHCCP DNSP |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$11.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.95
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$6.13
|
| Rate for Payer: BCBS MAPPO |
$11.16
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$11.16
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.16
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$11.16
|
| Rate for Payer: Mclaren Medicare |
$11.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.72
|
| Rate for Payer: Meridian Medicaid |
$6.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$10.60
|
| Rate for Payer: PACE SWMI |
$11.16
|
| Rate for Payer: PHP Commercial |
$12.28
|
| Rate for Payer: PHP Medicaid |
$5.98
|
| Rate for Payer: PHP Medicare Advantage |
$11.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.74
|
| Rate for Payer: Priority Health Medicare |
$11.16
|
| Rate for Payer: Priority Health Narrow Network |
$31.00
|
| Rate for Payer: Railroad Medicare Medicare |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.16
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$5.84
|
| Rate for Payer: UHCCP DNSP |
$11.16
|
| Rate for Payer: UHCCP Medicaid |
$5.84
|
| Rate for Payer: VA VA |
$11.16
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| 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 ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| 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 |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| 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 |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.79
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$44.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$7.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.12
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.30
|
| Rate for Payer: BCBS Trust/PPO |
$58.33
|
| Rate for Payer: BCN Commercial |
$58.33
|
| Rate for Payer: BCN Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.30
|
| Rate for Payer: Healthscope Commercial |
$68.63
|
| Rate for Payer: Healthscope Whirlpool |
$70.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.30
|
| Rate for Payer: Mclaren Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$7.30
|
| Rate for Payer: Mclaren Medicare |
$7.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.67
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Medicare |
$6.93
|
| Rate for Payer: PACE SWMI |
$7.30
|
| Rate for Payer: PHP Commercial |
$8.03
|
| Rate for Payer: PHP Medicaid |
$3.91
|
| Rate for Payer: PHP Medicare Advantage |
$7.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33.89
|
| Rate for Payer: Priority Health Medicare |
$7.30
|
| Rate for Payer: Priority Health Narrow Network |
$27.12
|
| Rate for Payer: Railroad Medicare Medicare |
$7.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.30
|
| Rate for Payer: UHC Exchange |
$11.31
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHCCP DNSP |
$7.30
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: VA VA |
$7.30
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$53.06 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: BCBS Trust/PPO |
$58.10
|
| Rate for Payer: BCN Commercial |
$58.10
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$68.63
|
| Rate for Payer: Healthscope Whirlpool |
$70.75
|
| Rate for Payer: Mclaren Commercial |
$63.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
|
|
HC ANTI THROMBIN III
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.20 |
| Max. Negotiated Rate |
$50.94 |
| Rate for Payer: Aetna Commercial |
$45.85
|
| Rate for Payer: ASR ASR |
$49.41
|
| Rate for Payer: BCBS Trust/PPO |
$41.83
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$49.41
|
| Rate for Payer: Healthscope Whirlpool |
$50.94
|
| Rate for Payer: Mclaren Commercial |
$45.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.83
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$157.38 |
| Rate for Payer: Aetna Commercial |
$45.85
|
| Rate for Payer: Aetna Medicare |
$11.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.81
|
| Rate for Payer: ASR ASR |
$49.41
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS MAPPO |
$11.85
|
| Rate for Payer: BCBS Trust/PPO |
$42.00
|
| Rate for Payer: BCN Commercial |
$42.00
|
| Rate for Payer: BCN Medicare Advantage |
$11.85
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.85
|
| Rate for Payer: Healthscope Commercial |
$49.41
|
| Rate for Payer: Healthscope Whirlpool |
$50.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.85
|
| Rate for Payer: Mclaren Commercial |
$45.85
|
| Rate for Payer: Mclaren Medicaid |
$11.85
|
| Rate for Payer: Mclaren Medicare |
$11.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Medicare |
$11.26
|
| Rate for Payer: PACE SWMI |
$11.85
|
| Rate for Payer: PHP Commercial |
$13.04
|
| Rate for Payer: PHP Medicaid |
$6.35
|
| Rate for Payer: PHP Medicare Advantage |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.38
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health Narrow Network |
$125.91
|
| Rate for Payer: Railroad Medicare Medicare |
$11.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.85
|
| Rate for Payer: UHC Exchange |
$18.37
|
| Rate for Payer: UHC Medicaid |
$6.20
|
| Rate for Payer: UHCCP DNSP |
$11.85
|
| Rate for Payer: UHCCP Medicaid |
$6.20
|
| Rate for Payer: VA VA |
$11.85
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$46.81 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$51.26
|
| Rate for Payer: BCN Commercial |
$51.26
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$60.55
|
| Rate for Payer: Healthscope Whirlpool |
$62.42
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$10.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.51
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$10.81
|
| Rate for Payer: BCBS Trust/PPO |
$51.47
|
| Rate for Payer: BCN Commercial |
$51.47
|
| Rate for Payer: BCN Medicare Advantage |
$10.81
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$60.55
|
| Rate for Payer: Healthscope Whirlpool |
$62.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.81
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$10.81
|
| Rate for Payer: Mclaren Medicare |
$10.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.35
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PACE Medicare |
$10.27
|
| Rate for Payer: PACE SWMI |
$10.81
|
| Rate for Payer: PHP Commercial |
$11.89
|
| Rate for Payer: PHP Medicaid |
$5.79
|
| Rate for Payer: PHP Medicare Advantage |
$10.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$54.69
|
| Rate for Payer: Priority Health Medicare |
$10.81
|
| Rate for Payer: Priority Health Narrow Network |
$43.76
|
| Rate for Payer: Railroad Medicare Medicare |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.81
|
| Rate for Payer: UHC Exchange |
$16.76
|
| Rate for Payer: UHC Medicaid |
$5.65
|
| Rate for Payer: UHCCP DNSP |
$10.81
|
| Rate for Payer: UHCCP Medicaid |
$5.65
|
| Rate for Payer: VA VA |
$10.81
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| 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 ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.83 |
| Max. Negotiated Rate |
$77.07 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$43.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.56
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$23.97
|
| Rate for Payer: BCBS MAPPO |
$43.65
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$43.65
|
| 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 |
$43.65
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$43.65
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$43.65
|
| Rate for Payer: Mclaren Medicare |
$43.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.83
|
| Rate for Payer: Meridian Medicaid |
$23.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.02
|
| 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 |
$41.47
|
| Rate for Payer: PACE SWMI |
$43.65
|
| Rate for Payer: PHP Commercial |
$48.02
|
| Rate for Payer: PHP Medicaid |
$23.40
|
| Rate for Payer: PHP Medicare Advantage |
$43.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$77.07
|
| Rate for Payer: Priority Health Medicare |
$43.65
|
| Rate for Payer: Priority Health Narrow Network |
$61.66
|
| Rate for Payer: Railroad Medicare Medicare |
$43.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.65
|
| Rate for Payer: UHC Exchange |
$67.66
|
| Rate for Payer: UHC Medicaid |
$22.83
|
| Rate for Payer: UHCCP DNSP |
$43.65
|
| Rate for Payer: UHCCP Medicaid |
$22.83
|
| Rate for Payer: VA VA |
$43.65
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
IP
|
$853.42
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$640.07 |
| Max. Negotiated Rate |
$853.42 |
| Rate for Payer: Aetna Commercial |
$768.08
|
| Rate for Payer: ASR ASR |
$827.82
|
| Rate for Payer: BCBS Trust/PPO |
$700.83
|
| Rate for Payer: BCN Commercial |
$700.83
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cofinity Commercial |
$802.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.74
|
| Rate for Payer: Healthscope Commercial |
$827.82
|
| Rate for Payer: Healthscope Whirlpool |
$853.42
|
| Rate for Payer: Mclaren Commercial |
$768.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.41
|
| Rate for Payer: Nomi Health Commercial |
$699.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$640.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.01
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
OP
|
$853.42
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$315.77 |
| Max. Negotiated Rate |
$853.42 |
| Rate for Payer: Aetna Commercial |
$768.08
|
| Rate for Payer: Aetna Medicare |
$315.77
|
| Rate for Payer: ASR ASR |
$827.82
|
| Rate for Payer: BCBS Complete |
$341.37
|
| Rate for Payer: BCBS Trust/PPO |
$703.64
|
| Rate for Payer: BCN Commercial |
$703.64
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cofinity Commercial |
$802.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.74
|
| Rate for Payer: Healthscope Commercial |
$827.82
|
| Rate for Payer: Healthscope Whirlpool |
$853.42
|
| Rate for Payer: Mclaren Commercial |
$768.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$682.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.41
|
| Rate for Payer: Nomi Health Commercial |
$699.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$640.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$747.77
|
| Rate for Payer: Priority Health Narrow Network |
$598.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.01
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,347.24
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,010.43 |
| Max. Negotiated Rate |
$1,347.24 |
| Rate for Payer: Aetna Commercial |
$1,212.52
|
| Rate for Payer: ASR ASR |
$1,306.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.35
|
| Rate for Payer: BCN Commercial |
$1,106.35
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cofinity Commercial |
$1,266.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,077.79
|
| Rate for Payer: Healthscope Commercial |
$1,306.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,347.24
|
| Rate for Payer: Mclaren Commercial |
$1,212.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,145.15
|
| Rate for Payer: Nomi Health Commercial |
$1,104.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,185.57
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
OP
|
$1,347.24
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,347.24 |
| Rate for Payer: Aetna Commercial |
$1,212.52
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,306.82
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.80
|
| Rate for Payer: BCN Commercial |
$1,110.80
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cofinity Commercial |
$1,266.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,077.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,306.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,347.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,212.52
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,145.15
|
| Rate for Payer: Nomi Health Commercial |
$1,104.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.43
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,180.45
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$944.42
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,185.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$624.65 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Trust/PPO |
$683.95
|
| Rate for Payer: BCN Commercial |
$683.95
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$686.70
|
| Rate for Payer: BCN Commercial |
$686.70
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$729.76
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$583.84
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC APHERESIS
|
Facility
|
OP
|
$2,606.60
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$964.44 |
| Max. Negotiated Rate |
$2,606.60 |
| Rate for Payer: Aetna Commercial |
$2,345.94
|
| Rate for Payer: Aetna Medicare |
$964.44
|
| Rate for Payer: ASR ASR |
$2,528.40
|
| Rate for Payer: BCBS Complete |
$1,042.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,149.14
|
| Rate for Payer: BCN Commercial |
$2,149.14
|
| Rate for Payer: Cash Price |
$2,085.28
|
| Rate for Payer: Cofinity Commercial |
$2,450.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,085.28
|
| Rate for Payer: Healthscope Commercial |
$2,528.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,606.60
|
| Rate for Payer: Mclaren Commercial |
$2,345.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,085.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,215.61
|
| Rate for Payer: Nomi Health Commercial |
$2,137.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,283.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,827.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,293.81
|
|
