|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna Commercial |
$96.46
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$103.96
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$88.37
|
| Rate for Payer: BCN Commercial |
$88.37
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$100.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$103.96
|
| Rate for Payer: Healthscope Whirlpool |
$107.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$96.46
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| 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 |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| 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 |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.91
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$75.13
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.39 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna Commercial |
$96.46
|
| Rate for Payer: ASR ASR |
$103.96
|
| Rate for Payer: BCBS Trust/PPO |
$88.02
|
| Rate for Payer: BCN Commercial |
$88.02
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$100.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$103.96
|
| Rate for Payer: Healthscope Whirlpool |
$107.18
|
| Rate for Payer: Mclaren Commercial |
$96.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.32
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$96.57 |
| Rate for Payer: Aetna Commercial |
$86.91
|
| 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 |
$93.67
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$79.62
|
| Rate for Payer: BCN Commercial |
$79.62
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$90.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$93.67
|
| Rate for Payer: Healthscope Whirlpool |
$96.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$86.91
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| 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 |
$28.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| 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 |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$84.61
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$67.70
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.43 |
| Max. Negotiated Rate |
$96.57 |
| Rate for Payer: Aetna Commercial |
$86.91
|
| Rate for Payer: ASR ASR |
$93.67
|
| Rate for Payer: BCBS Trust/PPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$79.30
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$90.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Healthscope Commercial |
$93.67
|
| Rate for Payer: Healthscope Whirlpool |
$96.57
|
| Rate for Payer: Mclaren Commercial |
$86.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.98
|
|
|
HC BCR / ABL FISH
|
Facility
|
IP
|
$133.71
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$100.28 |
| Max. Negotiated Rate |
$133.71 |
| Rate for Payer: Aetna Commercial |
$120.34
|
| Rate for Payer: ASR ASR |
$129.70
|
| Rate for Payer: BCBS Trust/PPO |
$109.80
|
| Rate for Payer: BCN Commercial |
$109.80
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Commercial |
$125.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Healthscope Commercial |
$129.70
|
| Rate for Payer: Healthscope Whirlpool |
$133.71
|
| Rate for Payer: Mclaren Commercial |
$120.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$109.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.66
|
|
|
HC BCR / ABL FISH
|
Facility
|
OP
|
$133.71
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$133.71 |
| Rate for Payer: Aetna Commercial |
$120.34
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$129.70
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$110.24
|
| Rate for Payer: BCN Commercial |
$110.24
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Commercial |
$125.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$129.70
|
| Rate for Payer: Healthscope Whirlpool |
$133.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$120.34
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| 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 |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$109.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| 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 |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$117.16
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$93.73
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.39 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna Commercial |
$96.46
|
| Rate for Payer: ASR ASR |
$103.96
|
| Rate for Payer: BCBS Trust/PPO |
$88.02
|
| Rate for Payer: BCN Commercial |
$88.02
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$100.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$103.96
|
| Rate for Payer: Healthscope Whirlpool |
$107.18
|
| Rate for Payer: Mclaren Commercial |
$96.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.32
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna Commercial |
$96.46
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$103.96
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$88.37
|
| Rate for Payer: BCN Commercial |
$88.37
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$100.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$103.96
|
| Rate for Payer: Healthscope Whirlpool |
$107.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$96.46
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| 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 |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| 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 |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.91
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$75.13
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$79.43 |
| Rate for Payer: Aetna Commercial |
$71.49
|
| 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 |
$77.05
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$65.49
|
| Rate for Payer: BCN Commercial |
$65.49
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$74.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$77.05
|
| Rate for Payer: Healthscope Whirlpool |
$79.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$71.49
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| 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 |
$28.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| 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 |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$55.68
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$59.57 |
| Max. Negotiated Rate |
$79.43 |
| Rate for Payer: Aetna Commercial |
$71.49
|
| Rate for Payer: ASR ASR |
$77.05
|
| Rate for Payer: BCBS Trust/PPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$74.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Healthscope Commercial |
$77.05
|
| Rate for Payer: Healthscope Whirlpool |
$79.43
|
| Rate for Payer: Mclaren Commercial |
$71.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.90
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$397.95
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$298.46 |
| Max. Negotiated Rate |
$397.95 |
| Rate for Payer: Aetna Commercial |
$358.15
|
| Rate for Payer: ASR ASR |
$386.01
|
| Rate for Payer: BCBS Trust/PPO |
$326.80
|
| Rate for Payer: BCN Commercial |
$326.80
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cofinity Commercial |
$374.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.36
|
| Rate for Payer: Healthscope Commercial |
$386.01
|
| Rate for Payer: Healthscope Whirlpool |
$397.95
|
| Rate for Payer: Mclaren Commercial |
$358.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.26
|
| Rate for Payer: Nomi Health Commercial |
$326.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.20
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$397.95
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.75 |
| Max. Negotiated Rate |
$397.95 |
| Rate for Payer: Aetna Commercial |
$358.15
|
| Rate for Payer: Aetna Medicare |
$163.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: ASR ASR |
$386.01
|
| Rate for Payer: BCBS Complete |
$90.05
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$328.11
|
| Rate for Payer: BCN Commercial |
$328.11
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cofinity Commercial |
$374.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$386.01
|
| Rate for Payer: Healthscope Whirlpool |
$397.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.96
|
| Rate for Payer: Mclaren Commercial |
$358.15
|
| Rate for Payer: Mclaren Medicaid |
$163.96
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$90.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.26
|
| Rate for Payer: Nomi Health Commercial |
$326.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.46
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$180.36
|
| Rate for Payer: PHP Medicaid |
$87.88
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.48
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health Narrow Network |
$90.79
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.96
|
| Rate for Payer: UHC Exchange |
$254.14
|
| Rate for Payer: UHC Medicaid |
$85.75
|
| Rate for Payer: UHCCP DNSP |
$163.96
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: VA VA |
$163.96
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$259.28
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.75 |
| Max. Negotiated Rate |
$259.28 |
| Rate for Payer: Aetna Commercial |
$233.35
|
| Rate for Payer: Aetna Medicare |
$144.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.05
|
| Rate for Payer: ASR ASR |
$251.50
|
| Rate for Payer: BCBS Complete |
$79.55
|
| Rate for Payer: BCBS MAPPO |
$144.84
|
| Rate for Payer: BCBS Trust/PPO |
$213.78
|
| Rate for Payer: BCN Commercial |
$213.78
|
| Rate for Payer: BCN Medicare Advantage |
$144.84
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cofinity Commercial |
$243.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.84
|
| Rate for Payer: Healthscope Commercial |
$251.50
|
| Rate for Payer: Healthscope Whirlpool |
$259.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$144.84
|
| Rate for Payer: Mclaren Commercial |
$233.35
|
| Rate for Payer: Mclaren Medicaid |
$144.84
|
| Rate for Payer: Mclaren Medicare |
$144.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.08
|
| Rate for Payer: Meridian Medicaid |
$79.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.39
|
| Rate for Payer: Nomi Health Commercial |
$212.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.46
|
| Rate for Payer: PACE Medicare |
$137.60
|
| Rate for Payer: PACE SWMI |
$144.84
|
| Rate for Payer: PHP Commercial |
$159.32
|
| Rate for Payer: PHP Medicaid |
$77.63
|
| Rate for Payer: PHP Medicare Advantage |
$144.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.38
|
| Rate for Payer: Priority Health Medicare |
$144.84
|
| Rate for Payer: Priority Health Narrow Network |
$80.30
|
| Rate for Payer: Railroad Medicare Medicare |
$144.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.84
|
| Rate for Payer: UHC Exchange |
$224.50
|
| Rate for Payer: UHC Medicaid |
$75.75
|
| Rate for Payer: UHCCP DNSP |
$144.84
|
| Rate for Payer: UHCCP Medicaid |
$75.75
|
| Rate for Payer: VA VA |
$144.84
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$259.28
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$259.28 |
| Rate for Payer: Aetna Commercial |
$233.35
|
| Rate for Payer: ASR ASR |
$251.50
|
| Rate for Payer: BCBS Trust/PPO |
$212.92
|
| Rate for Payer: BCN Commercial |
$212.92
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cofinity Commercial |
$243.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.42
|
| Rate for Payer: Healthscope Commercial |
$251.50
|
| Rate for Payer: Healthscope Whirlpool |
$259.28
|
| Rate for Payer: Mclaren Commercial |
$233.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.39
|
| Rate for Payer: Nomi Health Commercial |
$212.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.17
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$384.20
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$384.20 |
| Rate for Payer: Aetna Commercial |
$345.78
|
| Rate for Payer: Aetna Medicare |
$214.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.27
|
| Rate for Payer: ASR ASR |
$372.67
|
| Rate for Payer: BCBS Complete |
$117.87
|
| Rate for Payer: BCBS MAPPO |
$214.62
|
| Rate for Payer: BCBS Trust/PPO |
$316.77
|
| Rate for Payer: BCN Commercial |
$316.77
|
| Rate for Payer: BCN Medicare Advantage |
$214.62
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cofinity Commercial |
$361.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.62
|
| Rate for Payer: Healthscope Commercial |
$372.67
|
| Rate for Payer: Healthscope Whirlpool |
$384.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$214.62
|
| Rate for Payer: Mclaren Commercial |
$345.78
|
| Rate for Payer: Mclaren Medicaid |
$214.62
|
| Rate for Payer: Mclaren Medicare |
$214.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.35
|
| Rate for Payer: Meridian Medicaid |
$117.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.57
|
| Rate for Payer: Nomi Health Commercial |
$315.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.15
|
| Rate for Payer: PACE Medicare |
$203.89
|
| Rate for Payer: PACE SWMI |
$214.62
|
| Rate for Payer: PHP Commercial |
$236.08
|
| Rate for Payer: PHP Medicaid |
$115.04
|
| Rate for Payer: PHP Medicare Advantage |
$214.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90.26
|
| Rate for Payer: Priority Health Medicare |
$214.62
|
| Rate for Payer: Priority Health Narrow Network |
$72.21
|
| Rate for Payer: Railroad Medicare Medicare |
$214.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$214.62
|
| Rate for Payer: UHC Exchange |
$332.66
|
| Rate for Payer: UHC Medicaid |
$112.25
|
| Rate for Payer: UHCCP DNSP |
$214.62
|
| Rate for Payer: UHCCP Medicaid |
$112.25
|
| Rate for Payer: VA VA |
$214.62
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$384.20
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$288.15 |
| Max. Negotiated Rate |
$384.20 |
| Rate for Payer: Aetna Commercial |
$345.78
|
| Rate for Payer: ASR ASR |
$372.67
|
| Rate for Payer: BCBS Trust/PPO |
$315.51
|
| Rate for Payer: BCN Commercial |
$315.51
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cofinity Commercial |
$361.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.36
|
| Rate for Payer: Healthscope Commercial |
$372.67
|
| Rate for Payer: Healthscope Whirlpool |
$384.20
|
| Rate for Payer: Mclaren Commercial |
$345.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.57
|
| Rate for Payer: Nomi Health Commercial |
$315.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.10
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$293.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.75 |
| Max. Negotiated Rate |
$293.50 |
| Rate for Payer: Aetna Commercial |
$264.15
|
| Rate for Payer: Aetna Medicare |
$163.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: ASR ASR |
$284.69
|
| Rate for Payer: BCBS Complete |
$90.05
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$241.99
|
| Rate for Payer: BCN Commercial |
$241.99
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$234.80
|
| Rate for Payer: Cash Price |
$234.80
|
| Rate for Payer: Cofinity Commercial |
$275.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$284.69
|
| Rate for Payer: Healthscope Whirlpool |
$293.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.96
|
| Rate for Payer: Mclaren Commercial |
$264.15
|
| Rate for Payer: Mclaren Medicaid |
$163.96
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$90.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.47
|
| Rate for Payer: Nomi Health Commercial |
$240.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.12
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$180.36
|
| Rate for Payer: PHP Medicaid |
$87.88
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.48
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health Narrow Network |
$90.79
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.96
|
| Rate for Payer: UHC Exchange |
$254.14
|
| Rate for Payer: UHC Medicaid |
$85.75
|
| Rate for Payer: UHCCP DNSP |
$163.96
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: VA VA |
$163.96
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$293.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$220.12 |
| Max. Negotiated Rate |
$293.50 |
| Rate for Payer: Aetna Commercial |
$264.15
|
| Rate for Payer: ASR ASR |
$284.69
|
| Rate for Payer: BCBS Trust/PPO |
$241.02
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: Cash Price |
$234.80
|
| Rate for Payer: Cofinity Commercial |
$275.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.80
|
| Rate for Payer: Healthscope Commercial |
$284.69
|
| Rate for Payer: Healthscope Whirlpool |
$293.50
|
| Rate for Payer: Mclaren Commercial |
$264.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.47
|
| Rate for Payer: Nomi Health Commercial |
$240.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.28
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$41.16 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$6.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$3.30
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.01
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$6.01
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: Meridian Medicaid |
$3.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$6.61
|
| Rate for Payer: PHP Medicaid |
$3.22
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health Narrow Network |
$32.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.01
|
| Rate for Payer: UHC Exchange |
$9.32
|
| Rate for Payer: UHC Medicaid |
$3.14
|
| Rate for Payer: UHCCP DNSP |
$6.01
|
| Rate for Payer: UHCCP Medicaid |
$3.14
|
| Rate for Payer: VA VA |
$6.01
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$41.13
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$41.13 |
| Rate for Payer: Aetna Commercial |
$37.02
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: ASR ASR |
$39.90
|
| Rate for Payer: BCBS Complete |
$5.59
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$33.91
|
| Rate for Payer: BCN Commercial |
$33.91
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: Cofinity Commercial |
$38.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$39.90
|
| Rate for Payer: Healthscope Whirlpool |
$41.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.18
|
| Rate for Payer: Mclaren Commercial |
$37.02
|
| Rate for Payer: Mclaren Medicaid |
$10.18
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: Meridian Medicaid |
$5.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.96
|
| Rate for Payer: Nomi Health Commercial |
$33.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.85
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$11.20
|
| Rate for Payer: PHP Medicaid |
$5.46
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.04
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow Network |
$28.83
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.18
|
| Rate for Payer: UHC Exchange |
$15.78
|
| Rate for Payer: UHC Medicaid |
$5.32
|
| Rate for Payer: UHCCP DNSP |
$10.18
|
| Rate for Payer: UHCCP Medicaid |
$5.32
|
| Rate for Payer: VA VA |
$10.18
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$41.13
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.85 |
| Max. Negotiated Rate |
$41.13 |
| Rate for Payer: Aetna Commercial |
$37.02
|
| Rate for Payer: ASR ASR |
$39.90
|
| Rate for Payer: BCBS Trust/PPO |
$33.78
|
| Rate for Payer: BCN Commercial |
$33.78
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: Cofinity Commercial |
$38.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$39.90
|
| Rate for Payer: Healthscope Whirlpool |
$41.13
|
| Rate for Payer: Mclaren Commercial |
$37.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.96
|
| Rate for Payer: Nomi Health Commercial |
$33.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.19
|
|
|
HC BDIAL F8A
|
Facility
|
IP
|
$68.29
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$68.29 |
| Rate for Payer: Aetna Commercial |
$61.46
|
| Rate for Payer: ASR ASR |
$66.24
|
| Rate for Payer: BCBS Trust/PPO |
$56.08
|
| Rate for Payer: BCN Commercial |
$56.08
|
| Rate for Payer: Cash Price |
$54.63
|
| Rate for Payer: Cofinity Commercial |
$64.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.63
|
| Rate for Payer: Healthscope Commercial |
$66.24
|
| Rate for Payer: Healthscope Whirlpool |
$68.29
|
| Rate for Payer: Mclaren Commercial |
$61.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.05
|
| Rate for Payer: Nomi Health Commercial |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.10
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$68.29
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$68.29 |
| Rate for Payer: Aetna Commercial |
$61.46
|
| Rate for Payer: Aetna Medicare |
$17.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: ASR ASR |
$66.24
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$56.31
|
| Rate for Payer: BCN Commercial |
$56.31
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$54.63
|
| Rate for Payer: Cash Price |
$54.63
|
| Rate for Payer: Cofinity Commercial |
$64.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$66.24
|
| Rate for Payer: Healthscope Whirlpool |
$68.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.90
|
| Rate for Payer: Mclaren Commercial |
$61.46
|
| Rate for Payer: Mclaren Medicaid |
$17.90
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.05
|
| Rate for Payer: Nomi Health Commercial |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.22
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$19.69
|
| Rate for Payer: PHP Medicaid |
$9.59
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.84
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$47.87
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.90
|
| Rate for Payer: UHC Exchange |
$27.75
|
| Rate for Payer: UHC Medicaid |
$9.36
|
| Rate for Payer: UHCCP DNSP |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.36
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC BDIAL FACTOR IX ASSAY
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 85250
|
| Hospital Charge Code |
30500030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$75.61 |
| Max. Negotiated Rate |
$100.82 |
| Rate for Payer: Aetna Commercial |
$90.74
|
| Rate for Payer: ASR ASR |
$97.80
|
| Rate for Payer: BCBS Trust/PPO |
$82.79
|
| Rate for Payer: BCN Commercial |
$82.79
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$97.80
|
| Rate for Payer: Healthscope Whirlpool |
$100.82
|
| Rate for Payer: Mclaren Commercial |
$90.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.72
|
|
