|
HC COXSACKIE B AB CMPT
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| 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 |
$19.79
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$7.13
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| 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 |
$7.13
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.56
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC COXSACKIE B AB CMPT
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$33.05
|
| Rate for Payer: ASR ASR |
$35.62
|
| Rate for Payer: BCBS Trust/PPO |
$28.47
|
| Rate for Payer: BCN Commercial |
$28.47
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$34.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Healthscope Whirlpool |
$35.62
|
| Rate for Payer: Mclaren Commercial |
$33.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.31
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$60.54 |
| Rate for Payer: Aetna Commercial |
$33.05
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$35.62
|
| Rate for Payer: BCBS Complete |
$11.95
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$28.47
|
| Rate for Payer: BCN Commercial |
$28.47
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$34.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Healthscope Whirlpool |
$35.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$33.05
|
| Rate for Payer: Mclaren Medicaid |
$11.38
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Medicaid |
$11.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.38
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.54
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$48.43
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.31
|
| Rate for Payer: UHC Medicare Advantage |
$21.43
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CPK
|
Facility
|
IP
|
$52.22
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.55 |
| Max. Negotiated Rate |
$52.22 |
| Rate for Payer: Aetna Commercial |
$47.00
|
| Rate for Payer: ASR ASR |
$50.65
|
| Rate for Payer: BCBS Trust/PPO |
$40.49
|
| Rate for Payer: BCN Commercial |
$40.49
|
| Rate for Payer: Cash Price |
$41.78
|
| Rate for Payer: Cofinity Commercial |
$49.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.78
|
| Rate for Payer: Healthscope Commercial |
$52.22
|
| Rate for Payer: Healthscope Whirlpool |
$50.65
|
| Rate for Payer: Mclaren Commercial |
$47.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.95
|
|
|
HC CPK
|
Facility
|
OP
|
$52.22
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$52.22 |
| Rate for Payer: Aetna Commercial |
$47.00
|
| Rate for Payer: Aetna Medicare |
$6.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.14
|
| Rate for Payer: ASR ASR |
$50.65
|
| Rate for Payer: BCBS Complete |
$3.74
|
| Rate for Payer: BCBS MAPPO |
$6.51
|
| Rate for Payer: BCBS Trust/PPO |
$40.49
|
| Rate for Payer: BCN Commercial |
$40.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.51
|
| Rate for Payer: Cash Price |
$41.78
|
| Rate for Payer: Cash Price |
$41.78
|
| Rate for Payer: Cofinity Commercial |
$49.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.51
|
| Rate for Payer: Healthscope Commercial |
$52.22
|
| Rate for Payer: Healthscope Whirlpool |
$50.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.51
|
| Rate for Payer: Mclaren Commercial |
$47.00
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Mclaren Medicare |
$6.51
|
| Rate for Payer: Meridian Medicaid |
$3.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.39
|
| Rate for Payer: PACE Medicare |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.51
|
| Rate for Payer: PHP Commercial |
$7.16
|
| Rate for Payer: PHP Medicaid |
$3.56
|
| Rate for Payer: PHP Medicare Advantage |
$6.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.72
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health Narrow Network |
$38.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.95
|
| Rate for Payer: UHC Medicare Advantage |
$6.71
|
| Rate for Payer: VA VA |
$6.51
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
IP
|
$404.21
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$282.95 |
| Max. Negotiated Rate |
$404.21 |
| Rate for Payer: Aetna Commercial |
$363.79
|
| Rate for Payer: ASR ASR |
$392.08
|
| Rate for Payer: BCBS Trust/PPO |
$313.38
|
| Rate for Payer: BCN Commercial |
$313.38
|
| Rate for Payer: Cash Price |
$323.37
|
| Rate for Payer: Cofinity Commercial |
$379.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.37
|
| Rate for Payer: Healthscope Commercial |
$404.21
|
| Rate for Payer: Healthscope Whirlpool |
$392.08
|
| Rate for Payer: Mclaren Commercial |
$363.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$343.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.70
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
OP
|
$404.21
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$404.21 |
| Rate for Payer: Aetna Commercial |
$363.79
|
| Rate for Payer: Aetna Medicare |
$141.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.15
|
| Rate for Payer: ASR ASR |
$392.08
|
| Rate for Payer: BCBS Complete |
$81.40
|
| Rate for Payer: BCBS MAPPO |
$141.72
|
| Rate for Payer: BCBS Trust/PPO |
$313.38
|
| Rate for Payer: BCN Commercial |
$313.38
|
| Rate for Payer: BCN Medicare Advantage |
$141.72
|
| Rate for Payer: Cash Price |
$323.37
|
| Rate for Payer: Cash Price |
$323.37
|
| Rate for Payer: Cofinity Commercial |
$379.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.72
|
| Rate for Payer: Healthscope Commercial |
$404.21
|
| Rate for Payer: Healthscope Whirlpool |
$392.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$141.72
|
| Rate for Payer: Mclaren Commercial |
$363.79
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Mclaren Medicare |
$141.72
|
| Rate for Payer: Meridian Medicaid |
$81.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$343.58
|
| Rate for Payer: PACE Medicare |
$134.63
|
| Rate for Payer: PACE SWMI |
$141.72
|
| Rate for Payer: PHP Commercial |
$155.89
|
| Rate for Payer: PHP Medicaid |
$77.52
|
| Rate for Payer: PHP Medicare Advantage |
$141.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$141.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$141.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.70
|
| Rate for Payer: UHC Medicare Advantage |
$145.97
|
| Rate for Payer: VA VA |
$141.72
|
|
|
HC CPR
|
Facility
|
OP
|
$960.79
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$960.79 |
| Rate for Payer: Aetna Commercial |
$864.71
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$931.97
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$744.90
|
| Rate for Payer: BCN Commercial |
$744.90
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$768.63
|
| Rate for Payer: Cash Price |
$768.63
|
| Rate for Payer: Cofinity Commercial |
$903.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$960.79
|
| Rate for Payer: Healthscope Whirlpool |
$931.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$864.71
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$816.67
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.81
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$307.85
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.50
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC CPR
|
Facility
|
IP
|
$960.79
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$672.55 |
| Max. Negotiated Rate |
$960.79 |
| Rate for Payer: Aetna Commercial |
$864.71
|
| Rate for Payer: ASR ASR |
$931.97
|
| Rate for Payer: BCBS Trust/PPO |
$744.90
|
| Rate for Payer: BCN Commercial |
$744.90
|
| Rate for Payer: Cash Price |
$768.63
|
| Rate for Payer: Cofinity Commercial |
$903.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.63
|
| Rate for Payer: Healthscope Commercial |
$960.79
|
| Rate for Payer: Healthscope Whirlpool |
$931.97
|
| Rate for Payer: Mclaren Commercial |
$864.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$816.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.50
|
|
|
HC CRAB IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC CRAB IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CRE
|
Facility
|
IP
|
$1,424.73
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$997.31 |
| Max. Negotiated Rate |
$1,424.73 |
| Rate for Payer: Aetna Commercial |
$1,282.26
|
| Rate for Payer: ASR ASR |
$1,381.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.59
|
| Rate for Payer: BCN Commercial |
$1,104.59
|
| Rate for Payer: Cash Price |
$1,139.78
|
| Rate for Payer: Cofinity Commercial |
$1,339.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.78
|
| Rate for Payer: Healthscope Commercial |
$1,424.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,381.99
|
| Rate for Payer: Mclaren Commercial |
$1,282.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$997.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,253.76
|
|
|
HC CRE
|
Facility
|
OP
|
$1,424.73
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$569.89 |
| Max. Negotiated Rate |
$1,424.73 |
| Rate for Payer: Aetna Commercial |
$1,282.26
|
| Rate for Payer: ASR ASR |
$1,381.99
|
| Rate for Payer: BCBS Complete |
$569.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.59
|
| Rate for Payer: BCN Commercial |
$1,104.59
|
| Rate for Payer: Cash Price |
$1,139.78
|
| Rate for Payer: Cofinity Commercial |
$1,339.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.78
|
| Rate for Payer: Healthscope Commercial |
$1,424.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,381.99
|
| Rate for Payer: Mclaren Commercial |
$1,282.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$997.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,296.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,011.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,253.76
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
OP
|
$60.40
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$60.40 |
| Rate for Payer: Aetna Commercial |
$54.36
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$58.59
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$46.83
|
| Rate for Payer: BCN Commercial |
$46.83
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$48.32
|
| Rate for Payer: Cash Price |
$48.32
|
| Rate for Payer: Cofinity Commercial |
$56.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$60.40
|
| Rate for Payer: Healthscope Whirlpool |
$58.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$54.36
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.34
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.83
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.74
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$38.99
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.15
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
IP
|
$60.40
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.28 |
| Max. Negotiated Rate |
$60.40 |
| Rate for Payer: Aetna Commercial |
$54.36
|
| Rate for Payer: ASR ASR |
$58.59
|
| Rate for Payer: BCBS Trust/PPO |
$46.83
|
| Rate for Payer: BCN Commercial |
$46.83
|
| Rate for Payer: Cash Price |
$48.32
|
| Rate for Payer: Cofinity Commercial |
$56.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.32
|
| Rate for Payer: Healthscope Commercial |
$60.40
|
| Rate for Payer: Healthscope Whirlpool |
$58.59
|
| Rate for Payer: Mclaren Commercial |
$54.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.15
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
OP
|
$5,057.16
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,879.90 |
| Max. Negotiated Rate |
$5,057.16 |
| Rate for Payer: Aetna Commercial |
$4,551.44
|
| Rate for Payer: Aetna Medicare |
$3,436.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,295.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,295.94
|
| Rate for Payer: ASR ASR |
$4,905.45
|
| Rate for Payer: BCBS Complete |
$1,974.07
|
| Rate for Payer: BCBS MAPPO |
$3,436.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,920.82
|
| Rate for Payer: BCN Commercial |
$3,920.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,436.75
|
| Rate for Payer: Cash Price |
$4,045.73
|
| Rate for Payer: Cash Price |
$4,045.73
|
| Rate for Payer: Cofinity Commercial |
$4,753.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,045.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,436.75
|
| Rate for Payer: Healthscope Commercial |
$5,057.16
|
| Rate for Payer: Healthscope Whirlpool |
$4,905.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,436.75
|
| Rate for Payer: Mclaren Commercial |
$4,551.44
|
| Rate for Payer: Mclaren Medicaid |
$1,879.90
|
| Rate for Payer: Mclaren Medicare |
$3,436.75
|
| Rate for Payer: Meridian Medicaid |
$1,974.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,608.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,952.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,298.59
|
| Rate for Payer: PACE Medicare |
$3,264.91
|
| Rate for Payer: PACE SWMI |
$3,436.75
|
| Rate for Payer: PHP Commercial |
$3,780.42
|
| Rate for Payer: PHP Medicaid |
$1,879.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,436.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,879.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,540.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,602.02
|
| Rate for Payer: Priority Health Medicare |
$3,436.75
|
| Rate for Payer: Priority Health Narrow Network |
$3,590.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,436.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,450.30
|
| Rate for Payer: UHC Medicare Advantage |
$3,539.85
|
| Rate for Payer: VA VA |
$3,436.75
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
IP
|
$5,057.16
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,540.01 |
| Max. Negotiated Rate |
$5,057.16 |
| Rate for Payer: Aetna Commercial |
$4,551.44
|
| Rate for Payer: ASR ASR |
$4,905.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,920.82
|
| Rate for Payer: BCN Commercial |
$3,920.82
|
| Rate for Payer: Cash Price |
$4,045.73
|
| Rate for Payer: Cofinity Commercial |
$4,753.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,045.73
|
| Rate for Payer: Healthscope Commercial |
$5,057.16
|
| Rate for Payer: Healthscope Whirlpool |
$4,905.45
|
| Rate for Payer: Mclaren Commercial |
$4,551.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,540.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,450.30
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.78 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Aetna Medicare |
$9.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.82
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Complete |
$5.43
|
| Rate for Payer: BCBS MAPPO |
$9.46
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.46
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Mclaren Medicaid |
$5.17
|
| Rate for Payer: Mclaren Medicare |
$9.46
|
| Rate for Payer: Meridian Medicaid |
$5.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Medicare |
$8.99
|
| Rate for Payer: PACE SWMI |
$9.46
|
| Rate for Payer: PHP Commercial |
$10.41
|
| Rate for Payer: PHP Medicaid |
$5.17
|
| Rate for Payer: PHP Medicare Advantage |
$9.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.78
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow Network |
$24.62
|
| Rate for Payer: Railroad Medicare Medicare |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
| Rate for Payer: UHC Medicare Advantage |
$9.74
|
| Rate for Payer: VA VA |
$9.46
|
|
|
HC CREATININE SERUM
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$23.09 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.12
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$5.63
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.09
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health Narrow Network |
$18.47
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$5.27
|
| Rate for Payer: VA VA |
$5.12
|
|
|
HC CREATININE SERUM
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$128.27 |
| Rate for Payer: Aetna Commercial |
$34.11
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$36.76
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$35.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$37.90
|
| Rate for Payer: Healthscope Whirlpool |
$36.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$34.11
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.83
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.27
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$102.62
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.35
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.53 |
| Max. Negotiated Rate |
$37.90 |
| Rate for Payer: Aetna Commercial |
$34.11
|
| Rate for Payer: ASR ASR |
$36.76
|
| Rate for Payer: BCBS Trust/PPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$35.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$37.90
|
| Rate for Payer: Healthscope Whirlpool |
$36.76
|
| Rate for Payer: Mclaren Commercial |
$34.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.35
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
IP
|
$39.21
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$27.45 |
| Max. Negotiated Rate |
$39.21 |
| Rate for Payer: Aetna Commercial |
$35.29
|
| Rate for Payer: ASR ASR |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$30.40
|
| Rate for Payer: BCN Commercial |
$30.40
|
| Rate for Payer: Cash Price |
$31.37
|
| Rate for Payer: Cofinity Commercial |
$36.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.37
|
| Rate for Payer: Healthscope Commercial |
$39.21
|
| Rate for Payer: Healthscope Whirlpool |
$38.03
|
| Rate for Payer: Mclaren Commercial |
$35.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.50
|
|
