|
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
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
IP
|
$74.56
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.46 |
| Max. Negotiated Rate |
$74.56 |
| Rate for Payer: Aetna Commercial |
$67.10
|
| Rate for Payer: ASR ASR |
$72.32
|
| Rate for Payer: ASR Commercial |
$72.32
|
| Rate for Payer: BCBS Trust/PPO |
$60.76
|
| Rate for Payer: BCN Commercial |
$57.81
|
| Rate for Payer: Cash Price |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$70.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.65
|
| Rate for Payer: Healthscope Commercial |
$74.56
|
| Rate for Payer: Healthscope Whirlpool |
$72.32
|
| Rate for Payer: Mclaren Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.38
|
| Rate for Payer: Nomi Health Commercial |
$61.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.61
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
OP
|
$74.56
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$74.56 |
| Rate for Payer: Aetna Commercial |
$67.10
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.25
|
| Rate for Payer: ASR ASR |
$72.32
|
| Rate for Payer: ASR Commercial |
$72.32
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$61.06
|
| Rate for Payer: BCN Commercial |
$57.81
|
| Rate for Payer: BCN Medicare Advantage |
$17.00
|
| Rate for Payer: Cash Price |
$59.65
|
| Rate for Payer: Cash Price |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$70.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$74.56
|
| Rate for Payer: Healthscope Whirlpool |
$72.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.00
|
| Rate for Payer: Mclaren Commercial |
$67.10
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Mclaren Medicare |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.85
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.38
|
| Rate for Payer: Nomi Health Commercial |
$61.14
|
| Rate for Payer: PACE Medicare |
$16.15
|
| Rate for Payer: PACE SWMI |
$17.00
|
| Rate for Payer: PHP Commercial |
$18.70
|
| Rate for Payer: PHP Medicaid |
$9.11
|
| Rate for Payer: PHP Medicare Advantage |
$17.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.33
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow Network |
$52.27
|
| Rate for Payer: Railroad Medicare Medicare |
$17.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.00
|
| Rate for Payer: UHC Exchange |
$26.35
|
| Rate for Payer: UHC Medicare Advantage |
$17.00
|
| Rate for Payer: UHCCP DNSP |
$17.00
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$17.00
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
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 FETOPROTEIN SERUM
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.99 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.96
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: BCBS MAPPO |
$16.77
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: BCN Medicare Advantage |
$16.77
|
| 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 |
$16.77
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.77
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$8.99
|
| Rate for Payer: Mclaren Medicare |
$16.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.61
|
| Rate for Payer: Meridian Medicaid |
$9.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Medicare |
$15.93
|
| Rate for Payer: PACE SWMI |
$16.77
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicaid |
$8.99
|
| Rate for Payer: PHP Medicare Advantage |
$16.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.99
|
| 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 |
$16.77
|
| Rate for Payer: Priority Health Narrow Network |
$25.52
|
| Rate for Payer: Railroad Medicare Medicare |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.77
|
| Rate for Payer: UHC Exchange |
$25.99
|
| Rate for Payer: UHC Medicare Advantage |
$16.77
|
| Rate for Payer: UHCCP DNSP |
$16.77
|
| Rate for Payer: UHCCP Medicaid |
$8.99
|
| Rate for Payer: VA VA |
$16.77
|
|
|
HC ALPHA FETOPROTEIN TUMOR MARKER
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.92 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: ASR Commercial |
$62.56
|
| Rate for Payer: BCBS Trust/PPO |
$52.56
|
| Rate for Payer: BCN Commercial |
$50.01
|
| 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 |
$64.50
|
| Rate for Payer: Healthscope Whirlpool |
$62.56
|
| 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: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
|
|
HC ALPHA FETOPROTEIN TUMOR MARKER
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.99 |
| Max. Negotiated Rate |
$64.50 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.96
|
| Rate for Payer: ASR ASR |
$62.56
|
| Rate for Payer: ASR Commercial |
$62.56
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: BCBS MAPPO |
$16.77
|
| Rate for Payer: BCBS Trust/PPO |
$52.82
|
| Rate for Payer: BCN Commercial |
$50.01
|
| Rate for Payer: BCN Medicare Advantage |
$16.77
|
| Rate for Payer: Cash Price |
$51.60
|
| 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: Health Alliance Plan Medicare Advantage |
$16.77
|
| Rate for Payer: Healthscope Commercial |
$64.50
|
| Rate for Payer: Healthscope Whirlpool |
$62.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.77
|
| Rate for Payer: Mclaren Commercial |
$58.05
|
| Rate for Payer: Mclaren Medicaid |
$8.99
|
| Rate for Payer: Mclaren Medicare |
$16.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.61
|
| Rate for Payer: Meridian Medicaid |
$9.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: PACE Medicare |
$15.93
|
| Rate for Payer: PACE SWMI |
$16.77
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicaid |
$8.99
|
| Rate for Payer: PHP Medicare Advantage |
$16.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.51
|
| Rate for Payer: Priority Health Medicare |
$16.77
|
| Rate for Payer: Priority Health Narrow Network |
$45.21
|
| Rate for Payer: Railroad Medicare Medicare |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.77
|
| Rate for Payer: UHC Exchange |
$25.99
|
| Rate for Payer: UHC Medicare Advantage |
$16.77
|
| Rate for Payer: UHCCP DNSP |
$16.77
|
| Rate for Payer: UHCCP Medicaid |
$8.99
|
| Rate for Payer: VA VA |
$16.77
|
|
|
HC ALPHA-GLOBIN GENE ANALYSIS
|
Facility
|
OP
|
$421.61
|
|
|
Service Code
|
CPT 81269
|
| Hospital Charge Code |
31000088
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$108.49 |
| Max. Negotiated Rate |
$421.61 |
| Rate for Payer: Aetna Commercial |
$379.45
|
| Rate for Payer: Aetna Medicare |
$202.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$253.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$253.00
|
| Rate for Payer: ASR ASR |
$408.96
|
| Rate for Payer: ASR Commercial |
$408.96
|
| Rate for Payer: BCBS Complete |
$113.91
|
| Rate for Payer: BCBS MAPPO |
$202.40
|
| Rate for Payer: BCBS Trust/PPO |
$345.26
|
| Rate for Payer: BCN Commercial |
$326.87
|
| Rate for Payer: BCN Medicare Advantage |
$202.40
|
| Rate for Payer: Cash Price |
$337.29
|
| Rate for Payer: Cash Price |
$337.29
|
| Rate for Payer: Cofinity Commercial |
$396.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.40
|
| Rate for Payer: Healthscope Commercial |
$421.61
|
| Rate for Payer: Healthscope Whirlpool |
$408.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$202.40
|
| Rate for Payer: Mclaren Commercial |
$379.45
|
| Rate for Payer: Mclaren Medicaid |
$108.49
|
| Rate for Payer: Mclaren Medicare |
$202.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.52
|
| Rate for Payer: Meridian Medicaid |
$113.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.37
|
| Rate for Payer: Nomi Health Commercial |
$345.72
|
| Rate for Payer: PACE Medicare |
$192.28
|
| Rate for Payer: PACE SWMI |
$202.40
|
| Rate for Payer: PHP Commercial |
$222.64
|
| Rate for Payer: PHP Medicaid |
$108.49
|
| Rate for Payer: PHP Medicare Advantage |
$202.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.41
|
| Rate for Payer: Priority Health Medicare |
$202.40
|
| Rate for Payer: Priority Health Narrow Network |
$295.55
|
| Rate for Payer: Railroad Medicare Medicare |
$202.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.40
|
| Rate for Payer: UHC Exchange |
$313.72
|
| Rate for Payer: UHC Medicare Advantage |
$202.40
|
| Rate for Payer: UHCCP DNSP |
$202.40
|
| Rate for Payer: UHCCP Medicaid |
$108.49
|
| Rate for Payer: VA VA |
$202.40
|
|
|
HC ALPHA-GLOBIN GENE ANALYSIS
|
Facility
|
IP
|
$421.61
|
|
|
Service Code
|
CPT 81269
|
| Hospital Charge Code |
31000088
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$274.05 |
| Max. Negotiated Rate |
$421.61 |
| Rate for Payer: Aetna Commercial |
$379.45
|
| Rate for Payer: ASR ASR |
$408.96
|
| Rate for Payer: ASR Commercial |
$408.96
|
| Rate for Payer: BCBS Trust/PPO |
$343.57
|
| Rate for Payer: BCN Commercial |
$326.87
|
| Rate for Payer: Cash Price |
$337.29
|
| Rate for Payer: Cofinity Commercial |
$396.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.29
|
| Rate for Payer: Healthscope Commercial |
$421.61
|
| Rate for Payer: Healthscope Whirlpool |
$408.96
|
| Rate for Payer: Mclaren Commercial |
$379.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.37
|
| Rate for Payer: Nomi Health Commercial |
$345.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.02
|
|
|
HC ALTEPLASE RECOMBINANT, PER 1 MG
|
Facility
|
IP
|
$88.43
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
63600144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$88.43 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: ASR ASR |
$85.78
|
| Rate for Payer: ASR Commercial |
$85.78
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$68.56
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Commercial |
$83.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Healthscope Commercial |
$88.43
|
| Rate for Payer: Healthscope Whirlpool |
$85.78
|
| Rate for Payer: Mclaren Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$72.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.82
|
|
|
HC ALTEPLASE RECOMBINANT, PER 1 MG
|
Facility
|
OP
|
$88.43
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
63600144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.63 |
| Max. Negotiated Rate |
$146.40 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$94.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.06
|
| Rate for Payer: ASR ASR |
$85.78
|
| Rate for Payer: ASR Commercial |
$85.78
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$94.45
|
| Rate for Payer: BCBS Trust/PPO |
$72.42
|
| Rate for Payer: BCN Commercial |
$68.56
|
| Rate for Payer: BCN Medicare Advantage |
$94.45
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Commercial |
$83.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.45
|
| Rate for Payer: Healthscope Commercial |
$88.43
|
| Rate for Payer: Healthscope Whirlpool |
$85.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$94.45
|
| Rate for Payer: Mclaren Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$50.63
|
| Rate for Payer: Mclaren Medicare |
$94.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.17
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$72.51
|
| Rate for Payer: PACE Medicare |
$89.73
|
| Rate for Payer: PACE SWMI |
$94.45
|
| Rate for Payer: PHP Commercial |
$103.89
|
| Rate for Payer: PHP Medicaid |
$50.63
|
| Rate for Payer: PHP Medicare Advantage |
$94.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.48
|
| Rate for Payer: Priority Health Medicare |
$94.45
|
| Rate for Payer: Priority Health Narrow Network |
$61.99
|
| Rate for Payer: Railroad Medicare Medicare |
$94.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.45
|
| Rate for Payer: UHC Exchange |
$146.40
|
| Rate for Payer: UHC Medicare Advantage |
$94.45
|
| Rate for Payer: UHCCP DNSP |
$94.45
|
| Rate for Payer: UHCCP Medicaid |
$50.63
|
| Rate for Payer: VA VA |
$94.45
|
|
|
HC ALTERNARIA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200027
|
|
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 ALTERNARIA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200027
|
|
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 ALUMINUM
|
Facility
|
OP
|
$56.18
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
30100088
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.66 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$50.56
|
| Rate for Payer: Aetna Medicare |
$25.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.85
|
| Rate for Payer: ASR ASR |
$54.49
|
| Rate for Payer: ASR Commercial |
$54.49
|
| Rate for Payer: BCBS Complete |
$14.34
|
| Rate for Payer: BCBS MAPPO |
$25.48
|
| Rate for Payer: BCBS Trust/PPO |
$46.01
|
| Rate for Payer: BCN Commercial |
$43.56
|
| Rate for Payer: BCN Medicare Advantage |
$25.48
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$52.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.48
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Healthscope Whirlpool |
$54.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.48
|
| Rate for Payer: Mclaren Commercial |
$50.56
|
| Rate for Payer: Mclaren Medicaid |
$13.66
|
| Rate for Payer: Mclaren Medicare |
$25.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.75
|
| Rate for Payer: Meridian Medicaid |
$14.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: PACE Medicare |
$24.21
|
| Rate for Payer: PACE SWMI |
$25.48
|
| Rate for Payer: PHP Commercial |
$28.03
|
| Rate for Payer: PHP Medicaid |
$13.66
|
| Rate for Payer: PHP Medicare Advantage |
$25.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.22
|
| Rate for Payer: Priority Health Medicare |
$25.48
|
| Rate for Payer: Priority Health Narrow Network |
$39.38
|
| Rate for Payer: Railroad Medicare Medicare |
$25.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.48
|
| Rate for Payer: UHC Exchange |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$25.48
|
| Rate for Payer: UHCCP DNSP |
$25.48
|
| Rate for Payer: UHCCP Medicaid |
$13.66
|
| Rate for Payer: VA VA |
$25.48
|
|
|
HC ALUMINUM
|
Facility
|
IP
|
$56.18
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
30100088
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.52 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$50.56
|
| Rate for Payer: ASR ASR |
$54.49
|
| Rate for Payer: ASR Commercial |
$54.49
|
| Rate for Payer: BCBS Trust/PPO |
$45.78
|
| Rate for Payer: BCN Commercial |
$43.56
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$52.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Healthscope Whirlpool |
$54.49
|
| Rate for Payer: Mclaren Commercial |
$50.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.44
|
|
|
HC AMIKACIN LEVEL
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
30100006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.99 |
| Max. Negotiated Rate |
$78.45 |
| Rate for Payer: Aetna Commercial |
$70.61
|
| Rate for Payer: ASR ASR |
$76.10
|
| Rate for Payer: ASR Commercial |
$76.10
|
| Rate for Payer: BCBS Trust/PPO |
$63.93
|
| Rate for Payer: BCN Commercial |
$60.82
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$73.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$78.45
|
| Rate for Payer: Healthscope Whirlpool |
$76.10
|
| Rate for Payer: Mclaren Commercial |
$70.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.04
|
|
|
HC AMIKACIN LEVEL
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
30100006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$78.45 |
| Rate for Payer: Aetna Commercial |
$70.61
|
| Rate for Payer: Aetna Medicare |
$15.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: ASR ASR |
$76.10
|
| Rate for Payer: ASR Commercial |
$76.10
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$64.24
|
| Rate for Payer: BCN Commercial |
$60.82
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$73.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$78.45
|
| Rate for Payer: Healthscope Whirlpool |
$76.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.08
|
| Rate for Payer: Mclaren Commercial |
$70.61
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: PHP Medicaid |
$8.08
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.74
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$54.99
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$23.37
|
| Rate for Payer: UHC Medicare Advantage |
$15.08
|
| Rate for Payer: UHCCP DNSP |
$15.08
|
| Rate for Payer: UHCCP Medicaid |
$8.08
|
| Rate for Payer: VA VA |
$15.08
|
|
|
HC AMINO ACID FRACTIONATION
|
Facility
|
IP
|
$158.14
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100091
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.79 |
| Max. Negotiated Rate |
$158.14 |
| Rate for Payer: Aetna Commercial |
$142.33
|
| Rate for Payer: ASR ASR |
$153.40
|
| Rate for Payer: ASR Commercial |
$153.40
|
| Rate for Payer: BCBS Trust/PPO |
$128.87
|
| Rate for Payer: BCN Commercial |
$122.61
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cofinity Commercial |
$148.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.51
|
| Rate for Payer: Healthscope Commercial |
$158.14
|
| Rate for Payer: Healthscope Whirlpool |
$153.40
|
| Rate for Payer: Mclaren Commercial |
$142.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Nomi Health Commercial |
$129.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.16
|
|
|
HC AMINO ACID FRACTIONATION
|
Facility
|
OP
|
$158.14
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100091
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$158.14 |
| Rate for Payer: Aetna Commercial |
$142.33
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$153.40
|
| Rate for Payer: ASR Commercial |
$153.40
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$129.50
|
| Rate for Payer: BCN Commercial |
$122.61
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cofinity Commercial |
$148.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$158.14
|
| Rate for Payer: Healthscope Whirlpool |
$153.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$142.33
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Nomi Health Commercial |
$129.67
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.56
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$110.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC AMINO ACID QUANT CSF
|
Facility
|
IP
|
$234.09
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100093
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: ASR ASR |
$227.07
|
| Rate for Payer: ASR Commercial |
$227.07
|
| Rate for Payer: BCBS Trust/PPO |
$190.76
|
| Rate for Payer: BCN Commercial |
$181.49
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$220.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Healthscope Whirlpool |
$227.07
|
| Rate for Payer: Mclaren Commercial |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.00
|
|
|
HC AMINO ACID QUANT CSF
|
Facility
|
OP
|
$234.09
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100093
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$227.07
|
| Rate for Payer: ASR Commercial |
$227.07
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$191.70
|
| Rate for Payer: BCN Commercial |
$181.49
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$220.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Healthscope Whirlpool |
$227.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$210.68
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.11
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$164.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC AMINO ACID QUANT RANDOM URINE
|
Facility
|
IP
|
$213.28
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100092
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$138.63 |
| Max. Negotiated Rate |
$213.28 |
| Rate for Payer: Aetna Commercial |
$191.95
|
| Rate for Payer: ASR ASR |
$206.88
|
| Rate for Payer: ASR Commercial |
$206.88
|
| Rate for Payer: BCBS Trust/PPO |
$173.80
|
| Rate for Payer: BCN Commercial |
$165.36
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$200.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Healthscope Commercial |
$213.28
|
| Rate for Payer: Healthscope Whirlpool |
$206.88
|
| Rate for Payer: Mclaren Commercial |
$191.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$174.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.69
|
|
|
HC AMINO ACID QUANT RANDOM URINE
|
Facility
|
OP
|
$213.28
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100092
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$213.28 |
| Rate for Payer: Aetna Commercial |
$191.95
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$206.88
|
| Rate for Payer: ASR Commercial |
$206.88
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$174.65
|
| Rate for Payer: BCN Commercial |
$165.36
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$200.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$213.28
|
| Rate for Payer: Healthscope Whirlpool |
$206.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$191.95
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$174.89
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.88
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$149.51
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC AMINOLEVULINIC ACID URINE
|
Facility
|
IP
|
$87.72
|
|
|
Service Code
|
CPT 82135
|
| Hospital Charge Code |
30100089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.02 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Aetna Commercial |
$78.95
|
| Rate for Payer: ASR ASR |
$85.09
|
| Rate for Payer: ASR Commercial |
$85.09
|
| Rate for Payer: BCBS Trust/PPO |
$71.48
|
| Rate for Payer: BCN Commercial |
$68.01
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$87.72
|
| Rate for Payer: Healthscope Whirlpool |
$85.09
|
| Rate for Payer: Mclaren Commercial |
$78.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.56
|
| Rate for Payer: Nomi Health Commercial |
$71.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.19
|
|
|
HC AMINOLEVULINIC ACID URINE
|
Facility
|
OP
|
$87.72
|
|
|
Service Code
|
CPT 82135
|
| Hospital Charge Code |
30100089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Aetna Commercial |
$78.95
|
| Rate for Payer: Aetna Medicare |
$16.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.56
|
| Rate for Payer: ASR ASR |
$85.09
|
| Rate for Payer: ASR Commercial |
$85.09
|
| Rate for Payer: BCBS Complete |
$9.26
|
| Rate for Payer: BCBS MAPPO |
$16.45
|
| Rate for Payer: BCBS Trust/PPO |
$71.83
|
| Rate for Payer: BCN Commercial |
$68.01
|
| Rate for Payer: BCN Medicare Advantage |
$16.45
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.45
|
| Rate for Payer: Healthscope Commercial |
$87.72
|
| Rate for Payer: Healthscope Whirlpool |
$85.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.45
|
| Rate for Payer: Mclaren Commercial |
$78.95
|
| Rate for Payer: Mclaren Medicaid |
$8.82
|
| Rate for Payer: Mclaren Medicare |
$16.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.56
|
| Rate for Payer: Nomi Health Commercial |
$71.93
|
| Rate for Payer: PACE Medicare |
$15.63
|
| Rate for Payer: PACE SWMI |
$16.45
|
| Rate for Payer: PHP Commercial |
$18.09
|
| Rate for Payer: PHP Medicaid |
$8.82
|
| Rate for Payer: PHP Medicare Advantage |
$16.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.86
|
| Rate for Payer: Priority Health Medicare |
$16.45
|
| Rate for Payer: Priority Health Narrow Network |
$61.49
|
| Rate for Payer: Railroad Medicare Medicare |
$16.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.45
|
| Rate for Payer: UHC Exchange |
$25.50
|
| Rate for Payer: UHC Medicare Advantage |
$16.45
|
| Rate for Payer: UHCCP DNSP |
$16.45
|
| Rate for Payer: UHCCP Medicaid |
$8.82
|
| Rate for Payer: VA VA |
$16.45
|
|
