|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$22.89 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.29
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Complete |
$3.28
|
| Rate for Payer: BCBS MAPPO |
$5.83
|
| Rate for Payer: BCBS Trust/PPO |
$18.74
|
| Rate for Payer: BCN Commercial |
$17.75
|
| Rate for Payer: BCN Medicare Advantage |
$5.83
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.83
|
| Rate for Payer: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.83
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Mclaren Medicaid |
$3.12
|
| Rate for Payer: Mclaren Medicare |
$5.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.12
|
| Rate for Payer: Meridian Medicaid |
$3.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Medicare |
$5.54
|
| Rate for Payer: PACE SWMI |
$5.83
|
| Rate for Payer: PHP Commercial |
$6.41
|
| Rate for Payer: PHP Medicaid |
$3.12
|
| Rate for Payer: PHP Medicare Advantage |
$5.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.06
|
| Rate for Payer: Priority Health Medicare |
$5.83
|
| Rate for Payer: Priority Health Narrow Network |
$16.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.83
|
| Rate for Payer: UHC Exchange |
$9.04
|
| Rate for Payer: UHC Medicare Advantage |
$5.83
|
| Rate for Payer: UHCCP DNSP |
$5.83
|
| Rate for Payer: UHCCP Medicaid |
$3.12
|
| Rate for Payer: VA VA |
$5.83
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$22.89 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCN Commercial |
$17.75
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
|
|
HC ALMONDS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALMONDS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
OP
|
$49.41
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$19.76 |
| Max. Negotiated Rate |
$49.41 |
| Rate for Payer: Aetna Commercial |
$44.47
|
| Rate for Payer: Aetna Medicare |
$24.70
|
| Rate for Payer: ASR ASR |
$47.93
|
| Rate for Payer: ASR Commercial |
$47.93
|
| Rate for Payer: BCBS Complete |
$19.76
|
| Rate for Payer: BCBS Trust/PPO |
$40.46
|
| Rate for Payer: BCN Commercial |
$38.31
|
| Rate for Payer: Cash Price |
$39.53
|
| Rate for Payer: Cofinity Commercial |
$46.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.53
|
| Rate for Payer: Healthscope Commercial |
$49.41
|
| Rate for Payer: Healthscope Whirlpool |
$47.93
|
| Rate for Payer: Mclaren Commercial |
$44.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.00
|
| Rate for Payer: Nomi Health Commercial |
$40.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.29
|
| Rate for Payer: Priority Health Narrow Network |
$34.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.48
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
IP
|
$49.41
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$49.41 |
| Rate for Payer: Aetna Commercial |
$44.47
|
| Rate for Payer: ASR ASR |
$47.93
|
| Rate for Payer: ASR Commercial |
$47.93
|
| Rate for Payer: BCBS Trust/PPO |
$40.26
|
| Rate for Payer: BCN Commercial |
$38.31
|
| Rate for Payer: Cash Price |
$39.53
|
| Rate for Payer: Cofinity Commercial |
$46.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.53
|
| Rate for Payer: Healthscope Commercial |
$49.41
|
| Rate for Payer: Healthscope Whirlpool |
$47.93
|
| Rate for Payer: Mclaren Commercial |
$44.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.00
|
| Rate for Payer: Nomi Health Commercial |
$40.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.48
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
IP
|
$16.78
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.91 |
| Max. Negotiated Rate |
$16.78 |
| Rate for Payer: Aetna Commercial |
$15.10
|
| Rate for Payer: ASR ASR |
$16.28
|
| Rate for Payer: ASR Commercial |
$16.28
|
| Rate for Payer: BCBS Trust/PPO |
$13.67
|
| Rate for Payer: BCN Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$15.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$16.78
|
| Rate for Payer: Healthscope Whirlpool |
$16.28
|
| Rate for Payer: Mclaren Commercial |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.26
|
| Rate for Payer: Nomi Health Commercial |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.77
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
OP
|
$16.78
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.71 |
| Max. Negotiated Rate |
$16.78 |
| Rate for Payer: Aetna Commercial |
$15.10
|
| Rate for Payer: Aetna Medicare |
$8.39
|
| Rate for Payer: ASR ASR |
$16.28
|
| Rate for Payer: ASR Commercial |
$16.28
|
| Rate for Payer: BCBS Complete |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$13.74
|
| Rate for Payer: BCN Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$15.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$16.78
|
| Rate for Payer: Healthscope Whirlpool |
$16.28
|
| Rate for Payer: Mclaren Commercial |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.26
|
| Rate for Payer: Nomi Health Commercial |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.70
|
| Rate for Payer: Priority Health Narrow Network |
$11.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.77
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
IP
|
$42.31
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$42.31 |
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: ASR ASR |
$41.04
|
| Rate for Payer: ASR Commercial |
$41.04
|
| Rate for Payer: BCBS Trust/PPO |
$34.48
|
| Rate for Payer: BCN Commercial |
$32.80
|
| Rate for Payer: Cash Price |
$33.85
|
| Rate for Payer: Cofinity Commercial |
$39.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.85
|
| Rate for Payer: Healthscope Commercial |
$42.31
|
| Rate for Payer: Healthscope Whirlpool |
$41.04
|
| Rate for Payer: Mclaren Commercial |
$38.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.96
|
| Rate for Payer: Nomi Health Commercial |
$34.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.23
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
OP
|
$42.31
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.92 |
| Max. Negotiated Rate |
$42.31 |
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna Medicare |
$21.16
|
| Rate for Payer: ASR ASR |
$41.04
|
| Rate for Payer: ASR Commercial |
$41.04
|
| Rate for Payer: BCBS Complete |
$16.92
|
| Rate for Payer: BCBS Trust/PPO |
$34.65
|
| Rate for Payer: BCN Commercial |
$32.80
|
| Rate for Payer: Cash Price |
$33.85
|
| Rate for Payer: Cofinity Commercial |
$39.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.85
|
| Rate for Payer: Healthscope Commercial |
$42.31
|
| Rate for Payer: Healthscope Whirlpool |
$41.04
|
| Rate for Payer: Mclaren Commercial |
$38.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.96
|
| Rate for Payer: Nomi Health Commercial |
$34.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.23
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$59.16 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.07
|
| Rate for Payer: ASR ASR |
$57.39
|
| Rate for Payer: ASR Commercial |
$57.39
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$48.45
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$59.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.46
|
| Rate for Payer: Mclaren Commercial |
$53.24
|
| Rate for Payer: Mclaren Medicaid |
$7.75
|
| Rate for Payer: Mclaren Medicare |
$14.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$48.51
|
| Rate for Payer: PACE Medicare |
$13.74
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$15.91
|
| Rate for Payer: PHP Medicaid |
$7.75
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.84
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow Network |
$41.47
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.46
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicare Advantage |
$14.46
|
| Rate for Payer: UHCCP DNSP |
$14.46
|
| Rate for Payer: UHCCP Medicaid |
$7.75
|
| Rate for Payer: VA VA |
$14.46
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.45 |
| Max. Negotiated Rate |
$59.16 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| Rate for Payer: ASR ASR |
$57.39
|
| Rate for Payer: ASR Commercial |
$57.39
|
| Rate for Payer: BCBS Trust/PPO |
$48.21
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$59.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.39
|
| Rate for Payer: Mclaren Commercial |
$53.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$48.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.06
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
IP
|
$43.70
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.41 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$39.33
|
| Rate for Payer: ASR ASR |
$42.39
|
| Rate for Payer: ASR Commercial |
$42.39
|
| Rate for Payer: BCBS Trust/PPO |
$35.61
|
| Rate for Payer: BCN Commercial |
$33.88
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$41.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Healthscope Whirlpool |
$42.39
|
| Rate for Payer: Mclaren Commercial |
$39.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.46
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
OP
|
$43.70
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$39.33
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$42.39
|
| Rate for Payer: ASR Commercial |
$42.39
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$35.79
|
| Rate for Payer: BCN Commercial |
$33.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$41.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Healthscope Whirlpool |
$42.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$39.33
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.29
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$30.63
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.20
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$29.13
|
| 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: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.90
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$25.52
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.20
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$29.67
|
| Rate for Payer: BCN Commercial |
$28.23
|
| 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 |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| 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: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$51.12
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$7.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.69
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$43.76
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: UHCCP DNSP |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.20
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$50.87
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
OP
|
$58.65
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Aetna Commercial |
$52.78
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.07
|
| Rate for Payer: ASR ASR |
$56.89
|
| Rate for Payer: ASR Commercial |
$56.89
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$48.03
|
| Rate for Payer: BCN Commercial |
$45.47
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$55.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$58.65
|
| Rate for Payer: Healthscope Whirlpool |
$56.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.46
|
| Rate for Payer: Mclaren Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$7.75
|
| Rate for Payer: Mclaren Medicare |
$14.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: Nomi Health Commercial |
$48.09
|
| Rate for Payer: PACE Medicare |
$13.74
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$15.91
|
| Rate for Payer: PHP Medicaid |
$7.75
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.39
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow Network |
$41.11
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.46
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicare Advantage |
$14.46
|
| Rate for Payer: UHCCP DNSP |
$14.46
|
| Rate for Payer: UHCCP Medicaid |
$7.75
|
| Rate for Payer: VA VA |
$14.46
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
IP
|
$58.65
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Aetna Commercial |
$52.78
|
| Rate for Payer: ASR ASR |
$56.89
|
| Rate for Payer: ASR Commercial |
$56.89
|
| Rate for Payer: BCBS Trust/PPO |
$47.79
|
| Rate for Payer: BCN Commercial |
$45.47
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$55.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Healthscope Commercial |
$58.65
|
| Rate for Payer: Healthscope Whirlpool |
$56.89
|
| Rate for Payer: Mclaren Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: Nomi Health Commercial |
$48.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.61
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$173.40 |
| Rate for Payer: Aetna Commercial |
$156.06
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$168.20
|
| Rate for Payer: ASR Commercial |
$168.20
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$142.00
|
| Rate for Payer: BCN Commercial |
$134.44
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$163.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$173.40
|
| Rate for Payer: Healthscope Whirlpool |
$168.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$142.19
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.93
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$121.55
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
