|
HC BDIAL FACTOR IX ASSAY
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 85250
|
| Hospital Charge Code |
30500030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$100.82 |
| Rate for Payer: Aetna Commercial |
$90.74
|
| Rate for Payer: Aetna Medicare |
$19.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.80
|
| Rate for Payer: ASR ASR |
$97.80
|
| Rate for Payer: BCBS Complete |
$10.46
|
| Rate for Payer: BCBS MAPPO |
$19.04
|
| Rate for Payer: BCBS Trust/PPO |
$83.13
|
| Rate for Payer: BCN Commercial |
$83.13
|
| Rate for Payer: BCN Medicare Advantage |
$19.04
|
| Rate for Payer: Cash Price |
$80.66
|
| 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: Health Alliance Plan Medicare Advantage |
$19.04
|
| Rate for Payer: Healthscope Commercial |
$97.80
|
| Rate for Payer: Healthscope Whirlpool |
$100.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.04
|
| Rate for Payer: Mclaren Commercial |
$90.74
|
| Rate for Payer: Mclaren Medicaid |
$19.04
|
| Rate for Payer: Mclaren Medicare |
$19.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.99
|
| Rate for Payer: Meridian Medicaid |
$10.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.94
|
| 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: PACE Medicare |
$18.09
|
| Rate for Payer: PACE SWMI |
$19.04
|
| Rate for Payer: PHP Commercial |
$20.94
|
| Rate for Payer: PHP Medicaid |
$10.21
|
| Rate for Payer: PHP Medicare Advantage |
$19.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.34
|
| Rate for Payer: Priority Health Medicare |
$19.04
|
| Rate for Payer: Priority Health Narrow Network |
$70.67
|
| Rate for Payer: Railroad Medicare Medicare |
$19.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.04
|
| Rate for Payer: UHC Exchange |
$29.51
|
| Rate for Payer: UHC Medicaid |
$9.96
|
| Rate for Payer: UHCCP DNSP |
$19.04
|
| Rate for Payer: UHCCP Medicaid |
$9.96
|
| Rate for Payer: VA VA |
$19.04
|
|
|
HC BDIAL FIBC
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.06 |
| Max. Negotiated Rate |
$36.08 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: ASR ASR |
$35.00
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$33.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$35.00
|
| Rate for Payer: Healthscope Whirlpool |
$36.08
|
| Rate for Payer: Mclaren Commercial |
$32.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.75
|
|
|
HC BDIAL FIBC
|
Facility
|
OP
|
$36.08
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.15
|
| Rate for Payer: ASR ASR |
$35.00
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$29.75
|
| Rate for Payer: BCN Commercial |
$29.75
|
| Rate for Payer: BCN Medicare Advantage |
$9.72
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$33.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$35.00
|
| Rate for Payer: Healthscope Whirlpool |
$36.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.72
|
| Rate for Payer: Mclaren Commercial |
$32.47
|
| Rate for Payer: Mclaren Medicaid |
$9.72
|
| Rate for Payer: Mclaren Medicare |
$9.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.21
|
| Rate for Payer: Meridian Medicaid |
$5.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PACE Medicare |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.72
|
| Rate for Payer: PHP Commercial |
$10.69
|
| Rate for Payer: PHP Medicaid |
$5.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.89
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health Narrow Network |
$63.92
|
| Rate for Payer: Railroad Medicare Medicare |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.72
|
| Rate for Payer: UHC Exchange |
$15.07
|
| Rate for Payer: UHC Medicaid |
$5.08
|
| Rate for Payer: UHCCP DNSP |
$9.72
|
| Rate for Payer: UHCCP Medicaid |
$5.08
|
| Rate for Payer: VA VA |
$9.72
|
|
|
HC BDIAL FXIII
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$9.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.39
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Complete |
$5.00
|
| Rate for Payer: BCBS MAPPO |
$9.11
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$29.57
|
| Rate for Payer: BCN Medicare Advantage |
$9.11
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.11
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.11
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Mclaren Medicare |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.57
|
| Rate for Payer: Meridian Medicaid |
$5.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.11
|
| Rate for Payer: PHP Commercial |
$10.02
|
| Rate for Payer: PHP Medicaid |
$4.88
|
| Rate for Payer: PHP Medicare Advantage |
$9.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.43
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health Narrow Network |
$25.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.11
|
| Rate for Payer: UHC Exchange |
$14.12
|
| Rate for Payer: UHC Medicaid |
$4.76
|
| Rate for Payer: UHCCP DNSP |
$9.11
|
| Rate for Payer: UHCCP Medicaid |
$4.76
|
| Rate for Payer: VA VA |
$9.11
|
|
|
HC BDIAL FXIII
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$29.46
|
| Rate for Payer: BCN Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
|
|
HC BDIAL PTIN
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$29.71 |
| Rate for Payer: Aetna Commercial |
$26.74
|
| Rate for Payer: Aetna Medicare |
$4.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: ASR ASR |
$28.82
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$24.50
|
| Rate for Payer: BCN Commercial |
$24.50
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$28.82
|
| Rate for Payer: Healthscope Whirlpool |
$29.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.29
|
| Rate for Payer: Mclaren Commercial |
$26.74
|
| Rate for Payer: Mclaren Medicaid |
$4.29
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$4.72
|
| Rate for Payer: PHP Medicaid |
$2.30
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$28.45
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow Network |
$22.76
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.29
|
| Rate for Payer: UHC Exchange |
$6.65
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHCCP DNSP |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: VA VA |
$4.29
|
|
|
HC BDIAL PTIN
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$29.71 |
| Rate for Payer: Aetna Commercial |
$26.74
|
| Rate for Payer: ASR ASR |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$24.40
|
| Rate for Payer: BCN Commercial |
$24.40
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$28.82
|
| Rate for Payer: Healthscope Whirlpool |
$29.71
|
| Rate for Payer: Mclaren Commercial |
$26.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.14
|
|
|
HC BDIAL SFM
|
Facility
|
IP
|
$254.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$191.24 |
| Max. Negotiated Rate |
$254.98 |
| Rate for Payer: Aetna Commercial |
$229.48
|
| Rate for Payer: ASR ASR |
$247.33
|
| Rate for Payer: BCBS Trust/PPO |
$209.39
|
| Rate for Payer: BCN Commercial |
$209.39
|
| Rate for Payer: Cash Price |
$203.98
|
| Rate for Payer: Cofinity Commercial |
$239.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.98
|
| Rate for Payer: Healthscope Commercial |
$247.33
|
| Rate for Payer: Healthscope Whirlpool |
$254.98
|
| Rate for Payer: Mclaren Commercial |
$229.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.73
|
| Rate for Payer: Nomi Health Commercial |
$209.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.38
|
|
|
HC BDIAL SFM
|
Facility
|
OP
|
$254.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$254.98 |
| Rate for Payer: Aetna Commercial |
$229.48
|
| Rate for Payer: Aetna Medicare |
$80.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.58
|
| Rate for Payer: ASR ASR |
$247.33
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$80.46
|
| Rate for Payer: BCBS Trust/PPO |
$210.23
|
| Rate for Payer: BCN Commercial |
$210.23
|
| Rate for Payer: BCN Medicare Advantage |
$80.46
|
| Rate for Payer: Cash Price |
$203.98
|
| Rate for Payer: Cash Price |
$203.98
|
| Rate for Payer: Cofinity Commercial |
$239.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.46
|
| Rate for Payer: Healthscope Commercial |
$247.33
|
| Rate for Payer: Healthscope Whirlpool |
$254.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.46
|
| Rate for Payer: Mclaren Commercial |
$229.48
|
| Rate for Payer: Mclaren Medicaid |
$80.46
|
| Rate for Payer: Mclaren Medicare |
$80.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.48
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.73
|
| Rate for Payer: Nomi Health Commercial |
$209.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.24
|
| Rate for Payer: PACE Medicare |
$76.44
|
| Rate for Payer: PACE SWMI |
$80.46
|
| Rate for Payer: PHP Commercial |
$88.51
|
| Rate for Payer: PHP Medicaid |
$43.13
|
| Rate for Payer: PHP Medicare Advantage |
$80.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$223.41
|
| Rate for Payer: Priority Health Medicare |
$80.46
|
| Rate for Payer: Priority Health Narrow Network |
$178.74
|
| Rate for Payer: Railroad Medicare Medicare |
$80.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.46
|
| Rate for Payer: UHC Exchange |
$124.71
|
| Rate for Payer: UHC Medicaid |
$42.08
|
| Rate for Payer: UHCCP DNSP |
$80.46
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$80.46
|
|
|
HC BDIAL TT
|
Facility
|
OP
|
$25.60
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$25.60 |
| Rate for Payer: Aetna Commercial |
$23.04
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.21
|
| Rate for Payer: ASR ASR |
$24.83
|
| Rate for Payer: BCBS Complete |
$3.17
|
| Rate for Payer: BCBS MAPPO |
$5.77
|
| Rate for Payer: BCBS Trust/PPO |
$21.11
|
| Rate for Payer: BCN Commercial |
$21.11
|
| Rate for Payer: BCN Medicare Advantage |
$5.77
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$24.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.77
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Healthscope Whirlpool |
$25.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.77
|
| Rate for Payer: Mclaren Commercial |
$23.04
|
| Rate for Payer: Mclaren Medicaid |
$5.77
|
| Rate for Payer: Mclaren Medicare |
$5.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.06
|
| Rate for Payer: Meridian Medicaid |
$3.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.76
|
| Rate for Payer: Nomi Health Commercial |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.20
|
| Rate for Payer: PACE Medicare |
$5.48
|
| Rate for Payer: PACE SWMI |
$5.77
|
| Rate for Payer: PHP Commercial |
$6.35
|
| Rate for Payer: PHP Medicaid |
$3.09
|
| Rate for Payer: PHP Medicare Advantage |
$5.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.43
|
| Rate for Payer: Priority Health Medicare |
$5.77
|
| Rate for Payer: Priority Health Narrow Network |
$17.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.77
|
| Rate for Payer: UHC Exchange |
$8.94
|
| Rate for Payer: UHC Medicaid |
$3.02
|
| Rate for Payer: UHCCP DNSP |
$5.77
|
| Rate for Payer: UHCCP Medicaid |
$3.02
|
| Rate for Payer: VA VA |
$5.77
|
|
|
HC BDIAL TT
|
Facility
|
IP
|
$25.60
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$25.60 |
| Rate for Payer: Aetna Commercial |
$23.04
|
| Rate for Payer: ASR ASR |
$24.83
|
| Rate for Payer: BCBS Trust/PPO |
$21.02
|
| Rate for Payer: BCN Commercial |
$21.02
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$24.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.48
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Healthscope Whirlpool |
$25.60
|
| Rate for Payer: Mclaren Commercial |
$23.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.76
|
| Rate for Payer: Nomi Health Commercial |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.53
|
|
|
HC BDIAL VWAG
|
Facility
|
OP
|
$86.02
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$217.90 |
| Rate for Payer: Aetna Commercial |
$77.42
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$83.44
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$70.92
|
| Rate for Payer: BCN Commercial |
$70.92
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cofinity Commercial |
$80.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$83.44
|
| Rate for Payer: Healthscope Whirlpool |
$86.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$77.42
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.12
|
| Rate for Payer: Nomi Health Commercial |
$70.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.52
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.90
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$174.32
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC BDIAL VWAG
|
Facility
|
IP
|
$86.02
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$64.52 |
| Max. Negotiated Rate |
$86.02 |
| Rate for Payer: Aetna Commercial |
$77.42
|
| Rate for Payer: ASR ASR |
$83.44
|
| Rate for Payer: BCBS Trust/PPO |
$70.64
|
| Rate for Payer: BCN Commercial |
$70.64
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cofinity Commercial |
$80.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$83.44
|
| Rate for Payer: Healthscope Whirlpool |
$86.02
|
| Rate for Payer: Mclaren Commercial |
$77.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.12
|
| Rate for Payer: Nomi Health Commercial |
$70.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.70
|
|
|
HC BDIAL VWFX
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| 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 |
$99.93
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$84.94
|
| Rate for Payer: BCN Commercial |
$84.94
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$99.93
|
| Rate for Payer: Healthscope Whirlpool |
$103.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Mclaren Medicaid |
$30.86
|
| 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 |
$16.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.27
|
| 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 |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90.27
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$72.22
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC BDIAL VWFX
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$77.27 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$84.60
|
| Rate for Payer: BCN Commercial |
$84.60
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$99.93
|
| Rate for Payer: Healthscope Whirlpool |
$103.02
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
IP
|
$244.04
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$244.04 |
| Rate for Payer: Aetna Commercial |
$219.64
|
| Rate for Payer: ASR ASR |
$236.72
|
| Rate for Payer: BCBS Trust/PPO |
$200.41
|
| Rate for Payer: BCN Commercial |
$200.41
|
| Rate for Payer: Cash Price |
$195.23
|
| Rate for Payer: Cofinity Commercial |
$229.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.23
|
| Rate for Payer: Healthscope Commercial |
$236.72
|
| Rate for Payer: Healthscope Whirlpool |
$244.04
|
| Rate for Payer: Mclaren Commercial |
$219.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.43
|
| Rate for Payer: Nomi Health Commercial |
$200.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.76
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
OP
|
$244.04
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$219.64
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$236.72
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$201.21
|
| Rate for Payer: BCN Commercial |
$201.21
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$195.23
|
| Rate for Payer: Cash Price |
$195.23
|
| Rate for Payer: Cofinity Commercial |
$229.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$236.72
|
| Rate for Payer: Healthscope Whirlpool |
$244.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$219.64
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.43
|
| Rate for Payer: Nomi Health Commercial |
$200.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.03
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$167.06
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$133.64
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$29.71 |
| Rate for Payer: Aetna Commercial |
$26.74
|
| Rate for Payer: ASR ASR |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$24.40
|
| Rate for Payer: BCN Commercial |
$24.40
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$28.82
|
| Rate for Payer: Healthscope Whirlpool |
$29.71
|
| Rate for Payer: Mclaren Commercial |
$26.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.14
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Aetna Commercial |
$26.74
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.76
|
| Rate for Payer: ASR ASR |
$28.82
|
| Rate for Payer: BCBS Complete |
$4.73
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$24.50
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$24.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$28.82
|
| Rate for Payer: Healthscope Whirlpool |
$29.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.61
|
| Rate for Payer: Mclaren Commercial |
$26.74
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Meridian Medicaid |
$4.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Medicare |
$8.18
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Commercial |
$9.47
|
| Rate for Payer: PHP Medicaid |
$4.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.31
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$29.05
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.61
|
| Rate for Payer: UHC Exchange |
$13.35
|
| Rate for Payer: UHC Medicaid |
$4.50
|
| Rate for Payer: UHCCP DNSP |
$8.61
|
| Rate for Payer: UHCCP Medicaid |
$4.50
|
| Rate for Payer: VA VA |
$8.61
|
|
|
HC BEECH IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BEECH IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC BEHAVIOR COUNSEL OBESITY 15M
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
HCPCS G0447
|
| Hospital Charge Code |
51000133
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$256.50
|
| Rate for Payer: Aetna Medicare |
$101.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: ASR ASR |
$276.45
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$234.98
|
| Rate for Payer: BCN Commercial |
$234.98
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$267.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$276.45
|
| Rate for Payer: Healthscope Whirlpool |
$285.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$101.22
|
| Rate for Payer: Mclaren Commercial |
$256.50
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$55.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.25
|
| Rate for Payer: Nomi Health Commercial |
$233.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$111.34
|
| Rate for Payer: PHP Medicaid |
$54.25
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$249.72
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health Narrow Network |
$199.78
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$156.89
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP DNSP |
$101.22
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: VA VA |
$101.22
|
|
|
HC BEHAVIOR COUNSEL OBESITY 15M
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
HCPCS G0447
|
| Hospital Charge Code |
51000133
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$213.75 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$256.50
|
| Rate for Payer: ASR ASR |
$276.45
|
| Rate for Payer: BCBS Trust/PPO |
$234.04
|
| Rate for Payer: BCN Commercial |
$234.04
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$267.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$276.45
|
| Rate for Payer: Healthscope Whirlpool |
$285.00
|
| Rate for Payer: Mclaren Commercial |
$256.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.25
|
| Rate for Payer: Nomi Health Commercial |
$233.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.80
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
IP
|
$172.50
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$129.38 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Aetna Commercial |
$155.25
|
| Rate for Payer: ASR ASR |
$167.32
|
| Rate for Payer: BCBS Trust/PPO |
$141.66
|
| Rate for Payer: BCN Commercial |
$141.66
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$162.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Healthscope Commercial |
$167.32
|
| Rate for Payer: Healthscope Whirlpool |
$172.50
|
| Rate for Payer: Mclaren Commercial |
$155.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.80
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
OP
|
$172.50
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Aetna Commercial |
$155.25
|
| Rate for Payer: Aetna Medicare |
$29.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.69
|
| Rate for Payer: ASR ASR |
$167.32
|
| Rate for Payer: BCBS Complete |
$16.12
|
| Rate for Payer: BCBS MAPPO |
$29.35
|
| Rate for Payer: BCBS Trust/PPO |
$142.23
|
| Rate for Payer: BCN Commercial |
$142.23
|
| Rate for Payer: BCN Medicare Advantage |
$29.35
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$162.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.35
|
| Rate for Payer: Healthscope Commercial |
$167.32
|
| Rate for Payer: Healthscope Whirlpool |
$172.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.35
|
| Rate for Payer: Mclaren Commercial |
$155.25
|
| Rate for Payer: Mclaren Medicaid |
$29.35
|
| Rate for Payer: Mclaren Medicare |
$29.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.82
|
| Rate for Payer: Meridian Medicaid |
$16.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PACE Medicare |
$27.88
|
| Rate for Payer: PACE SWMI |
$29.35
|
| Rate for Payer: PHP Commercial |
$32.28
|
| Rate for Payer: PHP Medicaid |
$15.73
|
| Rate for Payer: PHP Medicare Advantage |
$29.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.22
|
| Rate for Payer: Priority Health Medicare |
$29.35
|
| Rate for Payer: Priority Health Narrow Network |
$74.58
|
| Rate for Payer: Railroad Medicare Medicare |
$29.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.35
|
| Rate for Payer: UHC Exchange |
$45.49
|
| Rate for Payer: UHC Medicaid |
$15.35
|
| Rate for Payer: UHCCP DNSP |
$29.35
|
| Rate for Payer: UHCCP Medicaid |
$15.35
|
| Rate for Payer: VA VA |
$29.35
|
|
