|
HC BENIGN HYPERKERATOTIC 2-4 LESIONS
|
Facility
|
IP
|
$283.50
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
76100039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.62 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: ASR ASR |
$275.00
|
| Rate for Payer: BCBS Trust/PPO |
$232.81
|
| Rate for Payer: BCN Commercial |
$232.81
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$283.50
|
| Rate for Payer: Mclaren Commercial |
$255.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.48
|
|
|
HC BENIGN HYPERKERATOTIC 2-4 LESIONS
|
Facility
|
OP
|
$283.50
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
76100039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$275.00
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$233.75
|
| Rate for Payer: BCN Commercial |
$233.75
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$283.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$255.15
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.40
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$198.73
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC BENIGN HYPERKERATOTIC >4 LESIONS
|
Facility
|
IP
|
$283.50
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
76100040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.62 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: ASR ASR |
$275.00
|
| Rate for Payer: BCBS Trust/PPO |
$232.81
|
| Rate for Payer: BCN Commercial |
$232.81
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$283.50
|
| Rate for Payer: Mclaren Commercial |
$255.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.48
|
|
|
HC BENIGN HYPERKERATOTIC >4 LESIONS
|
Facility
|
OP
|
$283.50
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
76100040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$275.00
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$233.75
|
| Rate for Payer: BCN Commercial |
$233.75
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$283.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$255.15
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.40
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$198.73
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC BENIGN HYPERKERATOTIC LESION
|
Facility
|
IP
|
$283.50
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
76100041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.62 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: ASR ASR |
$275.00
|
| Rate for Payer: BCBS Trust/PPO |
$232.81
|
| Rate for Payer: BCN Commercial |
$232.81
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$283.50
|
| Rate for Payer: Mclaren Commercial |
$255.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.48
|
|
|
HC BENIGN HYPERKERATOTIC LESION
|
Facility
|
OP
|
$283.50
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
76100041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$275.00
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$233.75
|
| Rate for Payer: BCN Commercial |
$233.75
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$275.00
|
| Rate for Payer: Healthscope Whirlpool |
$283.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$255.15
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.40
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$198.73
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC BENZO CONFIRMATION CMPT 1
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 80347
|
| Hospital Charge Code |
30000164
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$29.90
|
| Rate for Payer: BCN Commercial |
$29.90
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$35.32
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
|
HC BENZO CONFIRMATION CMPT 1
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 80347
|
| Hospital Charge Code |
30000164
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: Aetna Medicare |
$13.47
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: BCBS Complete |
$14.56
|
| Rate for Payer: BCBS Trust/PPO |
$30.02
|
| Rate for Payer: BCN Commercial |
$30.02
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$35.32
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.90
|
| Rate for Payer: Priority Health Narrow Network |
$25.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
|
HC BENZO CONFIRMATION CMPT 2
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 80368
|
| Hospital Charge Code |
30000165
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: BCBS Trust/PPO |
$27.34
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$32.29
|
| Rate for Payer: Healthscope Whirlpool |
$33.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC BENZO CONFIRMATION CMPT 2
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 80368
|
| Hospital Charge Code |
30000165
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: BCBS Complete |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$27.45
|
| Rate for Payer: BCN Commercial |
$27.45
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$32.29
|
| Rate for Payer: Healthscope Whirlpool |
$33.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.17
|
| Rate for Payer: Priority Health Narrow Network |
$23.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC BENZO CONFIRMATION, U
|
Facility
|
IP
|
$31.25
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
30000163
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.44 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$28.12
|
| Rate for Payer: ASR ASR |
$30.31
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cofinity Commercial |
$29.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$30.31
|
| Rate for Payer: Healthscope Whirlpool |
$31.25
|
| Rate for Payer: Mclaren Commercial |
$28.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.56
|
| Rate for Payer: Nomi Health Commercial |
$25.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.50
|
|
|
HC BENZO CONFIRMATION, U
|
Facility
|
OP
|
$31.25
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
30000163
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$31.25 |
| Rate for Payer: Aetna Commercial |
$28.12
|
| Rate for Payer: Aetna Medicare |
$11.56
|
| Rate for Payer: ASR ASR |
$30.31
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$25.77
|
| Rate for Payer: BCN Commercial |
$25.77
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cofinity Commercial |
$29.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$30.31
|
| Rate for Payer: Healthscope Whirlpool |
$31.25
|
| Rate for Payer: Mclaren Commercial |
$28.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.56
|
| Rate for Payer: Nomi Health Commercial |
$25.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.38
|
| Rate for Payer: Priority Health Narrow Network |
$21.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.50
|
|
|
HC BENZODIAZAPINE URIN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$111.25 |
| Rate for Payer: Aetna Commercial |
$100.12
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$107.91
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$91.73
|
| Rate for Payer: BCN Commercial |
$91.73
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$107.91
|
| Rate for Payer: Healthscope Whirlpool |
$111.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$100.12
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.48
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$77.99
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC BENZODIAZAPINE URIN
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$83.44 |
| Max. Negotiated Rate |
$111.25 |
| Rate for Payer: Aetna Commercial |
$100.12
|
| Rate for Payer: ASR ASR |
$107.91
|
| Rate for Payer: BCBS Trust/PPO |
$91.36
|
| Rate for Payer: BCN Commercial |
$91.36
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$107.91
|
| Rate for Payer: Healthscope Whirlpool |
$111.25
|
| Rate for Payer: Mclaren Commercial |
$100.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.90
|
|
|
HC BENZODIAZEPINE URINE CONFIRM
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30100594
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: BCBS Trust/PPO |
$53.18
|
| Rate for Payer: BCN Commercial |
$53.18
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$62.56
|
| Rate for Payer: Healthscope Whirlpool |
$64.50
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.51
|
| Rate for Payer: Priority Health Narrow Network |
$45.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
|
|
HC BENZODIAZEPINE URINE CONFIRM
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30100594
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.38 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: BCBS Trust/PPO |
$52.97
|
| Rate for Payer: BCN Commercial |
$52.97
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$62.56
|
| Rate for Payer: Healthscope Whirlpool |
$64.50
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
|
|
HC BERMUDA GRASS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200119
|
|
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 BERMUDA GRASS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200119
|
|
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 BETA 2 GLYCOPROTEIN I CMPT
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200139
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC BETA 2 GLYCOPROTEIN I CMPT
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200139
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGA M A
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200444
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGA M A
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200444
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200459
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200459
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG M A
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200140
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
