|
HC ACUNAV CATHETER
|
Facility
|
OP
|
$5,722.20
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,288.88 |
| Max. Negotiated Rate |
$5,722.20 |
| Rate for Payer: Aetna Commercial |
$5,149.98
|
| Rate for Payer: Aetna Medicare |
$2,861.10
|
| Rate for Payer: ASR ASR |
$5,550.53
|
| Rate for Payer: ASR Commercial |
$5,550.53
|
| Rate for Payer: BCBS Complete |
$2,288.88
|
| Rate for Payer: BCBS Trust/PPO |
$4,685.91
|
| Rate for Payer: BCN Commercial |
$4,436.42
|
| Rate for Payer: Cash Price |
$4,577.76
|
| Rate for Payer: Cofinity Commercial |
$5,378.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,577.76
|
| Rate for Payer: Healthscope Commercial |
$5,722.20
|
| Rate for Payer: Healthscope Whirlpool |
$5,550.53
|
| Rate for Payer: Mclaren Commercial |
$5,149.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,863.87
|
| Rate for Payer: Nomi Health Commercial |
$4,692.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,719.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,013.79
|
| Rate for Payer: Priority Health Narrow Network |
$4,011.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,035.54
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
OP
|
$137.02
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$54.81 |
| Max. Negotiated Rate |
$137.02 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$68.51
|
| Rate for Payer: ASR ASR |
$132.91
|
| Rate for Payer: ASR Commercial |
$132.91
|
| Rate for Payer: BCBS Complete |
$54.81
|
| Rate for Payer: BCBS Trust/PPO |
$112.21
|
| Rate for Payer: BCN Commercial |
$106.23
|
| Rate for Payer: Cash Price |
$109.62
|
| Rate for Payer: Cofinity Commercial |
$128.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.62
|
| Rate for Payer: Healthscope Commercial |
$137.02
|
| Rate for Payer: Healthscope Whirlpool |
$132.91
|
| Rate for Payer: Mclaren Commercial |
$123.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.47
|
| Rate for Payer: Nomi Health Commercial |
$112.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.06
|
| Rate for Payer: Priority Health Narrow Network |
$96.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.58
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
IP
|
$137.02
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$89.06 |
| Max. Negotiated Rate |
$137.02 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: ASR ASR |
$132.91
|
| Rate for Payer: ASR Commercial |
$132.91
|
| Rate for Payer: BCBS Trust/PPO |
$111.66
|
| Rate for Payer: BCN Commercial |
$106.23
|
| Rate for Payer: Cash Price |
$109.62
|
| Rate for Payer: Cofinity Commercial |
$128.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.62
|
| Rate for Payer: Healthscope Commercial |
$137.02
|
| Rate for Payer: Healthscope Whirlpool |
$132.91
|
| Rate for Payer: Mclaren Commercial |
$123.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.47
|
| Rate for Payer: Nomi Health Commercial |
$112.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.58
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: ASR Commercial |
$36.61
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$30.91
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$30.95
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.07
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$26.46
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$24.53 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: ASR Commercial |
$36.61
|
| Rate for Payer: BCBS Trust/PPO |
$30.75
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$74.81
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$75.18
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.44
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$64.35
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$510.70 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Aetna Commercial |
$707.13
|
| Rate for Payer: ASR ASR |
$762.13
|
| Rate for Payer: ASR Commercial |
$762.13
|
| Rate for Payer: BCBS Trust/PPO |
$640.27
|
| Rate for Payer: BCN Commercial |
$609.15
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$738.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Healthscope Commercial |
$785.70
|
| Rate for Payer: Healthscope Whirlpool |
$762.13
|
| Rate for Payer: Mclaren Commercial |
$707.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.84
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.42
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$367.47 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$707.13
|
| Rate for Payer: Aetna Medicare |
$685.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$856.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$856.96
|
| Rate for Payer: ASR ASR |
$762.13
|
| Rate for Payer: ASR Commercial |
$762.13
|
| Rate for Payer: BCBS Complete |
$385.84
|
| Rate for Payer: BCBS MAPPO |
$685.57
|
| Rate for Payer: BCBS Trust/PPO |
$643.41
|
| Rate for Payer: BCN Commercial |
$609.15
|
| Rate for Payer: BCN Medicare Advantage |
$685.57
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$738.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.57
|
| Rate for Payer: Healthscope Commercial |
$785.70
|
| Rate for Payer: Healthscope Whirlpool |
$762.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$685.57
|
| Rate for Payer: Mclaren Commercial |
$707.13
|
| Rate for Payer: Mclaren Medicaid |
$367.47
|
| Rate for Payer: Mclaren Medicare |
$685.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.85
|
| Rate for Payer: Meridian Medicaid |
$385.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$788.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.84
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: PACE Medicare |
$651.29
|
| Rate for Payer: PACE SWMI |
$685.57
|
| Rate for Payer: PHP Commercial |
$754.13
|
| Rate for Payer: PHP Medicaid |
$367.47
|
| Rate for Payer: PHP Medicare Advantage |
$685.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.43
|
| Rate for Payer: Priority Health Medicare |
$685.57
|
| Rate for Payer: Priority Health Narrow Network |
$550.78
|
| Rate for Payer: Railroad Medicare Medicare |
$685.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.57
|
| Rate for Payer: UHC Exchange |
$1,062.63
|
| Rate for Payer: UHC Medicare Advantage |
$685.57
|
| Rate for Payer: UHCCP DNSP |
$685.57
|
| Rate for Payer: UHCCP Medicaid |
$367.47
|
| Rate for Payer: VA VA |
$685.57
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
OP
|
$206.04
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$312.93 |
| Rate for Payer: Aetna Commercial |
$185.44
|
| 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 |
$199.86
|
| Rate for Payer: ASR Commercial |
$199.86
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$168.73
|
| Rate for Payer: BCN Commercial |
$159.74
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cofinity Commercial |
$193.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$206.04
|
| Rate for Payer: Healthscope Whirlpool |
$199.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$185.44
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.13
|
| Rate for Payer: Nomi Health Commercial |
$168.95
|
| 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 |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.93
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$250.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
IP
|
$206.04
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$133.93 |
| Max. Negotiated Rate |
$206.04 |
| Rate for Payer: Aetna Commercial |
$185.44
|
| Rate for Payer: ASR ASR |
$199.86
|
| Rate for Payer: ASR Commercial |
$199.86
|
| Rate for Payer: BCBS Trust/PPO |
$167.90
|
| Rate for Payer: BCN Commercial |
$159.74
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cofinity Commercial |
$193.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.83
|
| Rate for Payer: Healthscope Commercial |
$206.04
|
| Rate for Payer: Healthscope Whirlpool |
$199.86
|
| Rate for Payer: Mclaren Commercial |
$185.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.13
|
| Rate for Payer: Nomi Health Commercial |
$168.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.32
|
|
|
HC ADALIMUMAB, S
|
Facility
|
IP
|
$300.90
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$195.58 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: ASR ASR |
$291.87
|
| Rate for Payer: ASR Commercial |
$291.87
|
| Rate for Payer: BCBS Trust/PPO |
$245.20
|
| Rate for Payer: BCN Commercial |
$233.29
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cofinity Commercial |
$282.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.72
|
| Rate for Payer: Healthscope Commercial |
$300.90
|
| Rate for Payer: Healthscope Whirlpool |
$291.87
|
| Rate for Payer: Mclaren Commercial |
$270.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.76
|
| Rate for Payer: Nomi Health Commercial |
$246.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.79
|
|
|
HC ADALIMUMAB, S
|
Facility
|
OP
|
$300.90
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.67 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: Aetna Medicare |
$38.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: ASR ASR |
$291.87
|
| Rate for Payer: ASR Commercial |
$291.87
|
| Rate for Payer: BCBS Complete |
$21.71
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$246.41
|
| Rate for Payer: BCN Commercial |
$233.29
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cofinity Commercial |
$282.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$300.90
|
| Rate for Payer: Healthscope Whirlpool |
$291.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.57
|
| Rate for Payer: Mclaren Commercial |
$270.81
|
| Rate for Payer: Mclaren Medicaid |
$20.67
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Medicaid |
$21.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.76
|
| Rate for Payer: Nomi Health Commercial |
$246.74
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$42.43
|
| Rate for Payer: PHP Medicaid |
$20.67
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.16
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Narrow Network |
$35.33
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.57
|
| Rate for Payer: UHC Exchange |
$59.78
|
| Rate for Payer: UHC Medicare Advantage |
$38.57
|
| Rate for Payer: UHCCP DNSP |
$38.57
|
| Rate for Payer: UHCCP Medicaid |
$20.67
|
| Rate for Payer: VA VA |
$38.57
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
IP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$104.49 |
| Max. Negotiated Rate |
$160.75 |
| Rate for Payer: Aetna Commercial |
$144.68
|
| Rate for Payer: ASR ASR |
$155.93
|
| Rate for Payer: ASR Commercial |
$155.93
|
| Rate for Payer: BCBS Trust/PPO |
$131.00
|
| Rate for Payer: BCN Commercial |
$124.63
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$151.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Healthscope Commercial |
$160.75
|
| Rate for Payer: Healthscope Whirlpool |
$155.93
|
| Rate for Payer: Mclaren Commercial |
$144.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.46
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
OP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$160.75 |
| Rate for Payer: Aetna Commercial |
$144.68
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$155.93
|
| Rate for Payer: ASR Commercial |
$155.93
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$131.64
|
| Rate for Payer: BCN Commercial |
$124.63
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$151.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$160.75
|
| Rate for Payer: Healthscope Whirlpool |
$155.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$144.68
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.82
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.85
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$112.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
IP
|
$180.54
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.35 |
| Max. Negotiated Rate |
$180.54 |
| Rate for Payer: Aetna Commercial |
$162.49
|
| Rate for Payer: ASR ASR |
$175.12
|
| Rate for Payer: ASR Commercial |
$175.12
|
| Rate for Payer: BCBS Trust/PPO |
$147.12
|
| Rate for Payer: BCN Commercial |
$139.97
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cofinity Commercial |
$169.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.43
|
| Rate for Payer: Healthscope Commercial |
$180.54
|
| Rate for Payer: Healthscope Whirlpool |
$175.12
|
| Rate for Payer: Mclaren Commercial |
$162.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.46
|
| Rate for Payer: Nomi Health Commercial |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.88
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
OP
|
$180.54
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$312.93 |
| Rate for Payer: Aetna Commercial |
$162.49
|
| 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 |
$175.12
|
| Rate for Payer: ASR Commercial |
$175.12
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$147.84
|
| Rate for Payer: BCN Commercial |
$139.97
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cofinity Commercial |
$169.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$180.54
|
| Rate for Payer: Healthscope Whirlpool |
$175.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$162.49
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.46
|
| Rate for Payer: Nomi Health Commercial |
$148.04
|
| 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 |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.93
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$250.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: ASR Commercial |
$147.34
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$124.39
|
| Rate for Payer: BCN Commercial |
$117.77
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$151.90
|
| Rate for Payer: Healthscope Whirlpool |
$147.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.09
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$106.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP DNSP |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.74 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: ASR Commercial |
$147.34
|
| Rate for Payer: BCBS Trust/PPO |
$123.78
|
| Rate for Payer: BCN Commercial |
$117.77
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$151.90
|
| Rate for Payer: Healthscope Whirlpool |
$147.34
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
|
