|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
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 AMPLIFIED, VAN AB
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
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
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$138.53 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$12.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$24.20
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.95
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$7.08
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Medicaid |
$7.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.53
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: PHP Medicaid |
$7.08
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.53
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$110.82
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
| Rate for Payer: UHC Medicare Advantage |
$13.34
|
| Rate for Payer: VA VA |
$12.95
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.85 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$24.20
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
OP
|
$18.36
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Commercial |
$16.52
|
| Rate for Payer: Aetna Medicare |
$6.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: ASR ASR |
$17.81
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$14.23
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Healthscope Whirlpool |
$17.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.68
|
| Rate for Payer: Mclaren Commercial |
$16.52
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$7.35
|
| Rate for Payer: PHP Medicaid |
$3.65
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$15.60
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.16
|
| Rate for Payer: UHC Medicare Advantage |
$6.88
|
| Rate for Payer: VA VA |
$6.68
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
IP
|
$18.36
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$16.52
|
| Rate for Payer: ASR ASR |
$17.81
|
| Rate for Payer: BCBS Trust/PPO |
$14.23
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Healthscope Whirlpool |
$17.81
|
| Rate for Payer: Mclaren Commercial |
$16.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.16
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$116.98 |
| Rate for Payer: Aetna Commercial |
$42.30
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.49
|
| Rate for Payer: ASR ASR |
$45.59
|
| Rate for Payer: BCBS Complete |
$3.44
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$36.44
|
| Rate for Payer: BCN Commercial |
$36.44
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$47.00
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.99
|
| Rate for Payer: Mclaren Commercial |
$42.30
|
| Rate for Payer: Mclaren Medicaid |
$3.28
|
| Rate for Payer: Mclaren Medicare |
$5.99
|
| Rate for Payer: Meridian Medicaid |
$3.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Medicare |
$5.69
|
| Rate for Payer: PACE SWMI |
$5.99
|
| Rate for Payer: PHP Commercial |
$6.59
|
| Rate for Payer: PHP Medicaid |
$3.28
|
| Rate for Payer: PHP Medicare Advantage |
$5.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.98
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow Network |
$93.58
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.36
|
| Rate for Payer: UHC Medicare Advantage |
$6.17
|
| Rate for Payer: VA VA |
$5.99
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: Aetna Commercial |
$42.30
|
| Rate for Payer: ASR ASR |
$45.59
|
| Rate for Payer: BCBS Trust/PPO |
$36.44
|
| Rate for Payer: BCN Commercial |
$36.44
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$47.00
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Mclaren Commercial |
$42.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.36
|
|
|
HC CYCLOSPORINE
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
|
|
HC CYCLOSPORINE
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$119.04 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$18.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.05
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$9.87
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$19.86
|
| Rate for Payer: PHP Medicaid |
$9.87
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.04
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$95.23
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: VA VA |
$18.05
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: ASR ASR |
$63.05
|
| Rate for Payer: BCBS Trust/PPO |
$50.39
|
| Rate for Payer: BCN Commercial |
$50.39
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$65.00
|
| Rate for Payer: Healthscope Whirlpool |
$63.05
|
| Rate for Payer: Mclaren Commercial |
$58.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.20
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$18.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: ASR ASR |
$63.05
|
| Rate for Payer: BCBS Complete |
$10.64
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$50.39
|
| Rate for Payer: BCN Commercial |
$50.39
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$65.00
|
| Rate for Payer: Healthscope Whirlpool |
$63.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.52
|
| Rate for Payer: Mclaren Commercial |
$58.50
|
| Rate for Payer: Mclaren Medicaid |
$10.13
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Medicaid |
$10.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Medicaid |
$10.13
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$46.15
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.20
|
| Rate for Payer: UHC Medicare Advantage |
$19.08
|
| Rate for Payer: VA VA |
$18.52
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
IP
|
$66.46
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.52 |
| Max. Negotiated Rate |
$66.46 |
| Rate for Payer: Aetna Commercial |
$59.81
|
| Rate for Payer: ASR ASR |
$64.47
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$51.53
|
| Rate for Payer: Cash Price |
$53.17
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.17
|
| Rate for Payer: Healthscope Commercial |
$66.46
|
| Rate for Payer: Healthscope Whirlpool |
$64.47
|
| Rate for Payer: Mclaren Commercial |
$59.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.48
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
OP
|
$66.46
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$66.46 |
| Rate for Payer: Aetna Commercial |
$59.81
|
| Rate for Payer: Aetna Medicare |
$18.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: ASR ASR |
$64.47
|
| Rate for Payer: BCBS Complete |
$10.64
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$51.53
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$53.17
|
| Rate for Payer: Cash Price |
$53.17
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$66.46
|
| Rate for Payer: Healthscope Whirlpool |
$64.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.52
|
| Rate for Payer: Mclaren Commercial |
$59.81
|
| Rate for Payer: Mclaren Medicaid |
$10.13
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Medicaid |
$10.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.49
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Medicaid |
$10.13
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.48
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$47.19
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.48
|
| Rate for Payer: UHC Medicare Advantage |
$19.08
|
| Rate for Payer: VA VA |
$18.52
|
|
|
HC CYSTIC FIBROSIS CARRIER DETECT
|
Facility
|
OP
|
$1,715.49
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
31000098
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$304.46 |
| Max. Negotiated Rate |
$1,715.49 |
| Rate for Payer: Aetna Commercial |
$1,543.94
|
| Rate for Payer: Aetna Medicare |
$556.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$695.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$695.75
|
| Rate for Payer: ASR ASR |
$1,664.03
|
| Rate for Payer: BCBS Complete |
$319.71
|
| Rate for Payer: BCBS MAPPO |
$556.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.02
|
| Rate for Payer: BCN Commercial |
$1,330.02
|
| Rate for Payer: BCN Medicare Advantage |
$556.60
|
| Rate for Payer: Cash Price |
$1,372.39
|
| Rate for Payer: Cash Price |
$1,372.39
|
| Rate for Payer: Cofinity Commercial |
$1,612.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.60
|
| Rate for Payer: Healthscope Commercial |
$1,715.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,664.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$556.60
|
| Rate for Payer: Mclaren Commercial |
$1,543.94
|
| Rate for Payer: Mclaren Medicaid |
$304.46
|
| Rate for Payer: Mclaren Medicare |
$556.60
|
| Rate for Payer: Meridian Medicaid |
$319.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,458.17
|
| Rate for Payer: PACE Medicare |
$528.77
|
| Rate for Payer: PACE SWMI |
$556.60
|
| Rate for Payer: PHP Commercial |
$612.26
|
| Rate for Payer: PHP Medicaid |
$304.46
|
| Rate for Payer: PHP Medicare Advantage |
$556.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.30
|
| Rate for Payer: Priority Health Medicare |
$556.60
|
| Rate for Payer: Priority Health Narrow Network |
$639.44
|
| Rate for Payer: Railroad Medicare Medicare |
$556.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,509.63
|
| Rate for Payer: UHC Medicare Advantage |
$573.30
|
| Rate for Payer: VA VA |
$556.60
|
|
|
HC CYSTIC FIBROSIS CARRIER DETECT
|
Facility
|
IP
|
$1,715.49
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
31000098
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,200.84 |
| Max. Negotiated Rate |
$1,715.49 |
| Rate for Payer: Aetna Commercial |
$1,543.94
|
| Rate for Payer: ASR ASR |
$1,664.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.02
|
| Rate for Payer: BCN Commercial |
$1,330.02
|
| Rate for Payer: Cash Price |
$1,372.39
|
| Rate for Payer: Cofinity Commercial |
$1,612.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.39
|
| Rate for Payer: Healthscope Commercial |
$1,715.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,664.03
|
| Rate for Payer: Mclaren Commercial |
$1,543.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,458.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,509.63
|
|
|
HC CYSTINE 24HR URINE
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 82136
|
| Hospital Charge Code |
30100090
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$81.00
|
| Rate for Payer: Aetna Medicare |
$19.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.51
|
| Rate for Payer: ASR ASR |
$87.30
|
| Rate for Payer: BCBS Complete |
$11.26
|
| Rate for Payer: BCBS MAPPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$69.78
|
| Rate for Payer: BCN Commercial |
$69.78
|
| Rate for Payer: BCN Medicare Advantage |
$19.61
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$84.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Healthscope Whirlpool |
$87.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.61
|
| Rate for Payer: Mclaren Commercial |
$81.00
|
| Rate for Payer: Mclaren Medicaid |
$10.73
|
| Rate for Payer: Mclaren Medicare |
$19.61
|
| Rate for Payer: Meridian Medicaid |
$11.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Medicare |
$18.63
|
| Rate for Payer: PACE SWMI |
$19.61
|
| Rate for Payer: PHP Commercial |
$21.57
|
| Rate for Payer: PHP Medicaid |
$10.73
|
| Rate for Payer: PHP Medicare Advantage |
$19.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.90
|
| Rate for Payer: Priority Health Medicare |
$19.61
|
| Rate for Payer: Priority Health Narrow Network |
$63.90
|
| Rate for Payer: Railroad Medicare Medicare |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.20
|
| Rate for Payer: UHC Medicare Advantage |
$20.20
|
| Rate for Payer: VA VA |
$19.61
|
|
|
HC CYSTINE 24HR URINE
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 82136
|
| Hospital Charge Code |
30100090
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$81.00
|
| Rate for Payer: ASR ASR |
$87.30
|
| Rate for Payer: BCBS Trust/PPO |
$69.78
|
| Rate for Payer: BCN Commercial |
$69.78
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$84.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Healthscope Whirlpool |
$87.30
|
| Rate for Payer: Mclaren Commercial |
$81.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.20
|
|
|
HC CYSTOGRAFIN DILUTE PER ML
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
HCPCS Q9958
|
| Hospital Charge Code |
63600008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Aetna Commercial |
$0.24
|
| Rate for Payer: ASR ASR |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.11
|
| Rate for Payer: BCBS Trust/PPO |
$0.21
|
| Rate for Payer: BCN Commercial |
$0.21
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cofinity Commercial |
$0.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.22
|
| Rate for Payer: Healthscope Commercial |
$0.27
|
| Rate for Payer: Healthscope Whirlpool |
$0.26
|
| Rate for Payer: Mclaren Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.25
|
| Rate for Payer: Priority Health Narrow Network |
$0.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.24
|
|
|
HC CYSTOGRAFIN DILUTE PER ML
|
Facility
|
IP
|
$0.27
|
|
|
Service Code
|
HCPCS Q9958
|
| Hospital Charge Code |
63600008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Aetna Commercial |
$0.24
|
| Rate for Payer: ASR ASR |
$0.26
|
| Rate for Payer: BCBS Trust/PPO |
$0.21
|
| Rate for Payer: BCN Commercial |
$0.21
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cofinity Commercial |
$0.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.22
|
| Rate for Payer: Healthscope Commercial |
$0.27
|
| Rate for Payer: Healthscope Whirlpool |
$0.26
|
| Rate for Payer: Mclaren Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.24
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 1-3 IMPLANTS
|
Facility
|
OP
|
$6,151.43
|
|
|
Service Code
|
HCPCS C9739
|
| Hospital Charge Code |
76100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,515.86 |
| Max. Negotiated Rate |
$6,151.43 |
| Rate for Payer: Aetna Commercial |
$5,536.29
|
| Rate for Payer: Aetna Medicare |
$4,599.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,749.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,749.21
|
| Rate for Payer: ASR ASR |
$5,966.89
|
| Rate for Payer: BCBS Complete |
$2,641.88
|
| Rate for Payer: BCBS MAPPO |
$4,599.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,769.20
|
| Rate for Payer: BCN Commercial |
$4,769.20
|
| Rate for Payer: BCN Medicare Advantage |
$4,599.37
|
| Rate for Payer: Cash Price |
$4,921.14
|
| Rate for Payer: Cash Price |
$4,921.14
|
| Rate for Payer: Cofinity Commercial |
$5,782.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,921.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,599.37
|
| Rate for Payer: Healthscope Commercial |
$6,151.43
|
| Rate for Payer: Healthscope Whirlpool |
$5,966.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,599.37
|
| Rate for Payer: Mclaren Commercial |
$5,536.29
|
| Rate for Payer: Mclaren Medicaid |
$2,515.86
|
| Rate for Payer: Mclaren Medicare |
$4,599.37
|
| Rate for Payer: Meridian Medicaid |
$2,641.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,829.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,289.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,228.72
|
| Rate for Payer: PACE Medicare |
$4,369.40
|
| Rate for Payer: PACE SWMI |
$4,599.37
|
| Rate for Payer: PHP Commercial |
$5,059.31
|
| Rate for Payer: PHP Medicaid |
$2,515.86
|
| Rate for Payer: PHP Medicare Advantage |
$4,599.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,515.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,306.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,597.80
|
| Rate for Payer: Priority Health Medicare |
$4,599.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,367.52
|
| Rate for Payer: Railroad Medicare Medicare |
$4,599.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,413.26
|
| Rate for Payer: UHC Medicare Advantage |
$4,737.35
|
| Rate for Payer: VA VA |
$4,599.37
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 1-3 IMPLANTS
|
Facility
|
IP
|
$6,151.43
|
|
|
Service Code
|
HCPCS C9739
|
| Hospital Charge Code |
76100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,306.00 |
| Max. Negotiated Rate |
$6,151.43 |
| Rate for Payer: Aetna Commercial |
$5,536.29
|
| Rate for Payer: ASR ASR |
$5,966.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,769.20
|
| Rate for Payer: BCN Commercial |
$4,769.20
|
| Rate for Payer: Cash Price |
$4,921.14
|
| Rate for Payer: Cofinity Commercial |
$5,782.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,921.14
|
| Rate for Payer: Healthscope Commercial |
$6,151.43
|
| Rate for Payer: Healthscope Whirlpool |
$5,966.89
|
| Rate for Payer: Mclaren Commercial |
$5,536.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,228.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,306.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,413.26
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 4 OR MORE IMPLANTS
|
Facility
|
IP
|
$12,343.94
|
|
|
Service Code
|
HCPCS C9740
|
| Hospital Charge Code |
76100197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,640.76 |
| Max. Negotiated Rate |
$12,343.94 |
| Rate for Payer: Aetna Commercial |
$11,109.55
|
| Rate for Payer: ASR ASR |
$11,973.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,570.26
|
| Rate for Payer: BCN Commercial |
$9,570.26
|
| Rate for Payer: Cash Price |
$9,875.15
|
| Rate for Payer: Cofinity Commercial |
$11,603.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,875.15
|
| Rate for Payer: Healthscope Commercial |
$12,343.94
|
| Rate for Payer: Healthscope Whirlpool |
$11,973.62
|
| Rate for Payer: Mclaren Commercial |
$11,109.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,492.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,640.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,862.67
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 4 OR MORE IMPLANTS
|
Facility
|
OP
|
$12,343.94
|
|
|
Service Code
|
HCPCS C9740
|
| Hospital Charge Code |
76100197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,479.18 |
| Max. Negotiated Rate |
$12,343.94 |
| Rate for Payer: Aetna Commercial |
$11,109.55
|
| Rate for Payer: Aetna Medicare |
$8,188.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,235.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,235.78
|
| Rate for Payer: ASR ASR |
$11,973.62
|
| Rate for Payer: BCBS Complete |
$4,703.54
|
| Rate for Payer: BCBS MAPPO |
$8,188.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,570.26
|
| Rate for Payer: BCN Commercial |
$9,570.26
|
| Rate for Payer: BCN Medicare Advantage |
$8,188.62
|
| Rate for Payer: Cash Price |
$9,875.15
|
| Rate for Payer: Cash Price |
$9,875.15
|
| Rate for Payer: Cofinity Commercial |
$11,603.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,875.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,188.62
|
| Rate for Payer: Healthscope Commercial |
$12,343.94
|
| Rate for Payer: Healthscope Whirlpool |
$11,973.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,188.62
|
| Rate for Payer: Mclaren Commercial |
$11,109.55
|
| Rate for Payer: Mclaren Medicaid |
$4,479.18
|
| Rate for Payer: Mclaren Medicare |
$8,188.62
|
| Rate for Payer: Meridian Medicaid |
$4,703.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,598.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,416.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,492.35
|
| Rate for Payer: PACE Medicare |
$7,779.19
|
| Rate for Payer: PACE SWMI |
$8,188.62
|
| Rate for Payer: PHP Commercial |
$9,007.48
|
| Rate for Payer: PHP Medicaid |
$4,479.18
|
| Rate for Payer: PHP Medicare Advantage |
$8,188.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,479.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,640.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,232.99
|
| Rate for Payer: Priority Health Medicare |
$8,188.62
|
| Rate for Payer: Priority Health Narrow Network |
$8,764.20
|
| Rate for Payer: Railroad Medicare Medicare |
$8,188.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,862.67
|
| Rate for Payer: UHC Medicare Advantage |
$8,434.28
|
| Rate for Payer: VA VA |
$8,188.62
|
|
|
HC CYSTOMETROGRAM W/VP & UP
|
Facility
|
OP
|
$1,737.79
|
|
|
Service Code
|
CPT 51729
|
| Hospital Charge Code |
76100345
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$332.14 |
| Max. Negotiated Rate |
$1,737.79 |
| Rate for Payer: Aetna Commercial |
$1,564.01
|
| Rate for Payer: Aetna Medicare |
$607.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: ASR ASR |
$1,685.66
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.31
|
| Rate for Payer: BCN Commercial |
$1,347.31
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$1,390.23
|
| Rate for Payer: Cash Price |
$1,390.23
|
| Rate for Payer: Cofinity Commercial |
$1,633.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$1,737.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,685.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$607.20
|
| Rate for Payer: Mclaren Commercial |
$1,564.01
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,477.12
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$667.92
|
| Rate for Payer: PHP Medicaid |
$332.14
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,581.39
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.83
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,529.26
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: VA VA |
$607.20
|
|
