|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
OP
|
$15.34
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Aetna Commercial |
$13.81
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$14.88
|
| Rate for Payer: BCBS Complete |
$5.42
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$11.89
|
| Rate for Payer: BCN Commercial |
$11.89
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cofinity Commercial |
$14.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$15.34
|
| Rate for Payer: Healthscope Whirlpool |
$14.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$13.81
|
| Rate for Payer: Mclaren Medicaid |
$5.16
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Medicaid |
$5.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.04
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.16
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.70
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.50
|
| Rate for Payer: UHC Medicare Advantage |
$9.72
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: Aetna Medicare |
$8.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.51
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Complete |
$4.83
|
| Rate for Payer: BCBS MAPPO |
$8.41
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$8.41
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.41
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.41
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$4.60
|
| Rate for Payer: Mclaren Medicare |
$8.41
|
| Rate for Payer: Meridian Medicaid |
$4.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$7.99
|
| Rate for Payer: PACE SWMI |
$8.41
|
| Rate for Payer: PHP Commercial |
$9.25
|
| Rate for Payer: PHP Medicaid |
$4.60
|
| Rate for Payer: PHP Medicare Advantage |
$8.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.89
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health Narrow Network |
$56.09
|
| Rate for Payer: Railroad Medicare Medicare |
$8.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
| Rate for Payer: UHC Medicare Advantage |
$8.66
|
| Rate for Payer: VA VA |
$8.41
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.30 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.30 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$104.67 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.64
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Complete |
$4.43
|
| Rate for Payer: BCBS MAPPO |
$7.71
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$7.71
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.71
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$4.22
|
| Rate for Payer: Mclaren Medicare |
$7.71
|
| Rate for Payer: Meridian Medicaid |
$4.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$7.32
|
| Rate for Payer: PACE SWMI |
$7.71
|
| Rate for Payer: PHP Commercial |
$8.48
|
| Rate for Payer: PHP Medicaid |
$4.22
|
| Rate for Payer: PHP Medicare Advantage |
$7.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.67
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health Narrow Network |
$83.74
|
| Rate for Payer: Railroad Medicare Medicare |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
| Rate for Payer: UHC Medicare Advantage |
$7.94
|
| Rate for Payer: VA VA |
$7.71
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$428.40 |
| Max. Negotiated Rate |
$612.00 |
| Rate for Payer: Aetna Commercial |
$550.80
|
| Rate for Payer: ASR ASR |
$593.64
|
| Rate for Payer: BCBS Trust/PPO |
$474.48
|
| Rate for Payer: BCN Commercial |
$474.48
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$575.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$612.00
|
| Rate for Payer: Healthscope Whirlpool |
$593.64
|
| Rate for Payer: Mclaren Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.56
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$119.28 |
| Max. Negotiated Rate |
$612.00 |
| Rate for Payer: Aetna Commercial |
$550.80
|
| Rate for Payer: Aetna Medicare |
$218.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.58
|
| Rate for Payer: ASR ASR |
$593.64
|
| Rate for Payer: BCBS Complete |
$125.25
|
| Rate for Payer: BCBS MAPPO |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$474.48
|
| Rate for Payer: BCN Commercial |
$474.48
|
| Rate for Payer: BCN Medicare Advantage |
$218.06
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$575.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.06
|
| Rate for Payer: Healthscope Commercial |
$612.00
|
| Rate for Payer: Healthscope Whirlpool |
$593.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$218.06
|
| Rate for Payer: Mclaren Commercial |
$550.80
|
| Rate for Payer: Mclaren Medicaid |
$119.28
|
| Rate for Payer: Mclaren Medicare |
$218.06
|
| Rate for Payer: Meridian Medicaid |
$125.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PACE Medicare |
$207.16
|
| Rate for Payer: PACE SWMI |
$218.06
|
| Rate for Payer: PHP Commercial |
$239.87
|
| Rate for Payer: PHP Medicaid |
$119.28
|
| Rate for Payer: PHP Medicare Advantage |
$218.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.92
|
| Rate for Payer: Priority Health Medicare |
$218.06
|
| Rate for Payer: Priority Health Narrow Network |
$434.52
|
| Rate for Payer: Railroad Medicare Medicare |
$218.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.56
|
| Rate for Payer: UHC Medicare Advantage |
$224.60
|
| Rate for Payer: VA VA |
$218.06
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$61.05 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Complete |
$4.95
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.62
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$4.72
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Medicaid |
$4.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$9.48
|
| Rate for Payer: PHP Medicaid |
$4.72
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.05
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow Network |
$48.84
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC CULTURE SCREENING
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$125.19 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Complete |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.63
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$3.63
|
| Rate for Payer: Mclaren Medicare |
$6.63
|
| Rate for Payer: Meridian Medicaid |
$3.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$7.29
|
| Rate for Payer: PHP Medicaid |
$3.63
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.19
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow Network |
$100.15
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.83
|
| Rate for Payer: VA VA |
$6.63
|
|
|
HC CULTURE SCREENING
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.85 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
OP
|
$12.75
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$12.75 |
| Rate for Payer: Aetna Commercial |
$11.48
|
| Rate for Payer: ASR ASR |
$12.37
|
| Rate for Payer: BCBS Complete |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$9.89
|
| Rate for Payer: BCN Commercial |
$9.89
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$11.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$12.75
|
| Rate for Payer: Healthscope Whirlpool |
$12.37
|
| Rate for Payer: Mclaren Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.60
|
| Rate for Payer: Priority Health Narrow Network |
$9.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.22
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
IP
|
$12.75
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$12.75 |
| Rate for Payer: Aetna Commercial |
$11.48
|
| Rate for Payer: ASR ASR |
$12.37
|
| Rate for Payer: BCBS Trust/PPO |
$9.89
|
| Rate for Payer: BCN Commercial |
$9.89
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$11.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$12.75
|
| Rate for Payer: Healthscope Whirlpool |
$12.37
|
| Rate for Payer: Mclaren Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.22
|
|
|
HC CVC ACCESS TRAY
|
Facility
|
IP
|
$131.94
|
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$92.36 |
| Max. Negotiated Rate |
$131.94 |
| Rate for Payer: Aetna Commercial |
$118.75
|
| Rate for Payer: ASR ASR |
$127.98
|
| Rate for Payer: BCBS Trust/PPO |
$102.29
|
| Rate for Payer: BCN Commercial |
$102.29
|
| Rate for Payer: Cash Price |
$105.55
|
| Rate for Payer: Cofinity Commercial |
$124.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.55
|
| Rate for Payer: Healthscope Commercial |
$131.94
|
| Rate for Payer: Healthscope Whirlpool |
$127.98
|
| Rate for Payer: Mclaren Commercial |
$118.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.11
|
|
|
HC CVC ACCESS TRAY
|
Facility
|
OP
|
$131.94
|
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.78 |
| Max. Negotiated Rate |
$131.94 |
| Rate for Payer: Aetna Commercial |
$118.75
|
| Rate for Payer: ASR ASR |
$127.98
|
| Rate for Payer: BCBS Complete |
$52.78
|
| Rate for Payer: BCBS Trust/PPO |
$102.29
|
| Rate for Payer: BCN Commercial |
$102.29
|
| Rate for Payer: Cash Price |
$105.55
|
| Rate for Payer: Cofinity Commercial |
$124.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.55
|
| Rate for Payer: Healthscope Commercial |
$131.94
|
| Rate for Payer: Healthscope Whirlpool |
$127.98
|
| Rate for Payer: Mclaren Commercial |
$118.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.07
|
| Rate for Payer: Priority Health Narrow Network |
$93.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.11
|
|
|
HC CVC INSERT
|
Facility
|
IP
|
$2,495.63
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,746.94 |
| Max. Negotiated Rate |
$2,495.63 |
| Rate for Payer: Aetna Commercial |
$2,246.07
|
| Rate for Payer: ASR ASR |
$2,420.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.86
|
| Rate for Payer: BCN Commercial |
$1,934.86
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,345.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,495.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.76
|
| Rate for Payer: Mclaren Commercial |
$2,246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,196.15
|
|
|
HC CVC INSERT
|
Facility
|
OP
|
$2,495.63
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$998.25 |
| Max. Negotiated Rate |
$2,495.63 |
| Rate for Payer: Aetna Commercial |
$2,246.07
|
| Rate for Payer: ASR ASR |
$2,420.76
|
| Rate for Payer: BCBS Complete |
$998.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.86
|
| Rate for Payer: BCN Commercial |
$1,934.86
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,345.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,495.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.76
|
| Rate for Payer: Mclaren Commercial |
$2,246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,271.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,196.15
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$560.37 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$441.26
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$353.01
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC CVVHD INSERTION
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
27000053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$163.47 |
| Max. Negotiated Rate |
$408.67 |
| Rate for Payer: Aetna Commercial |
$367.80
|
| Rate for Payer: ASR ASR |
$396.41
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS Trust/PPO |
$316.84
|
| Rate for Payer: BCN Commercial |
$316.84
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$384.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$408.67
|
| Rate for Payer: Healthscope Whirlpool |
$396.41
|
| Rate for Payer: Mclaren Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.89
|
| Rate for Payer: Priority Health Narrow Network |
$290.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.63
|
|
|
HC CVVHD INSERTION
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
27000053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$286.07 |
| Max. Negotiated Rate |
$408.67 |
| Rate for Payer: Aetna Commercial |
$367.80
|
| Rate for Payer: ASR ASR |
$396.41
|
| Rate for Payer: BCBS Trust/PPO |
$316.84
|
| Rate for Payer: BCN Commercial |
$316.84
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$384.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$408.67
|
| Rate for Payer: Healthscope Whirlpool |
$396.41
|
| Rate for Payer: Mclaren Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.63
|
|
|
HC CVVH SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$619.07
|
|
| Hospital Charge Code |
27000611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$433.35 |
| Max. Negotiated Rate |
$619.07 |
| Rate for Payer: Aetna Commercial |
$557.16
|
| Rate for Payer: ASR ASR |
$600.50
|
| Rate for Payer: BCBS Trust/PPO |
$479.96
|
| Rate for Payer: BCN Commercial |
$479.96
|
| Rate for Payer: Cash Price |
$495.26
|
| Rate for Payer: Cofinity Commercial |
$581.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.26
|
| Rate for Payer: Healthscope Commercial |
$619.07
|
| Rate for Payer: Healthscope Whirlpool |
$600.50
|
| Rate for Payer: Mclaren Commercial |
$557.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$544.78
|
|
|
HC CVVH SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$619.07
|
|
| Hospital Charge Code |
27000611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$247.63 |
| Max. Negotiated Rate |
$619.07 |
| Rate for Payer: Aetna Commercial |
$557.16
|
| Rate for Payer: ASR ASR |
$600.50
|
| Rate for Payer: BCBS Complete |
$247.63
|
| Rate for Payer: BCBS Trust/PPO |
$479.96
|
| Rate for Payer: BCN Commercial |
$479.96
|
| Rate for Payer: Cash Price |
$495.26
|
| Rate for Payer: Cofinity Commercial |
$581.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.26
|
| Rate for Payer: Healthscope Commercial |
$619.07
|
| Rate for Payer: Healthscope Whirlpool |
$600.50
|
| Rate for Payer: Mclaren Commercial |
$557.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.35
|
| Rate for Payer: Priority Health Narrow Network |
$439.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$544.78
|
|
|
HC CX ID BY PCR AMP, ENTEROBACTERIACEA
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.44 |
| Max. Negotiated Rate |
$56.35 |
| Rate for Payer: Aetna Commercial |
$50.72
|
| Rate for Payer: ASR ASR |
$54.66
|
| Rate for Payer: BCBS Trust/PPO |
$43.69
|
| Rate for Payer: BCN Commercial |
$43.69
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$52.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.08
|
| Rate for Payer: Healthscope Commercial |
$56.35
|
| Rate for Payer: Healthscope Whirlpool |
$54.66
|
| Rate for Payer: Mclaren Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.59
|
|
|
HC CX ID BY PCR AMP, ENTEROBACTERIACEA
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$56.35 |
| Rate for Payer: Aetna Commercial |
$50.72
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$54.66
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.69
|
| Rate for Payer: BCN Commercial |
$43.69
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$52.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.35
|
| Rate for Payer: Healthscope Whirlpool |
$54.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.28
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$40.01
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.59
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
