|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$47.36
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$235.58 |
| Rate for Payer: Aetna Commercial |
$42.62
|
| Rate for Payer: Aetna Medicare |
$151.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: ASR ASR |
$45.94
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$39.05
|
| Rate for Payer: BCN Commercial |
$39.05
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$37.89
|
| Rate for Payer: Cash Price |
$37.89
|
| Rate for Payer: Cofinity Commercial |
$44.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: Healthscope Whirlpool |
$47.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.99
|
| Rate for Payer: Mclaren Commercial |
$42.62
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$83.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.26
|
| Rate for Payer: Nomi Health Commercial |
$38.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.52
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$167.19
|
| Rate for Payer: PHP Medicaid |
$81.47
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.50
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health Narrow Network |
$33.20
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$235.58
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP DNSP |
$151.99
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: VA VA |
$151.99
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$365.75
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$79.49 |
| Max. Negotiated Rate |
$365.75 |
| Rate for Payer: Aetna Commercial |
$329.18
|
| Rate for Payer: Aetna Medicare |
$151.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: ASR ASR |
$354.78
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$301.56
|
| Rate for Payer: BCN Commercial |
$301.56
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Commercial |
$343.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$354.78
|
| Rate for Payer: Healthscope Whirlpool |
$365.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.99
|
| Rate for Payer: Mclaren Commercial |
$329.18
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$83.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: Nomi Health Commercial |
$299.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.31
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$167.19
|
| Rate for Payer: PHP Medicaid |
$81.47
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$320.47
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health Narrow Network |
$256.39
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$235.58
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP DNSP |
$151.99
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: VA VA |
$151.99
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$365.75
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$274.31 |
| Max. Negotiated Rate |
$365.75 |
| Rate for Payer: Aetna Commercial |
$329.18
|
| Rate for Payer: ASR ASR |
$354.78
|
| Rate for Payer: BCBS Trust/PPO |
$300.35
|
| Rate for Payer: BCN Commercial |
$300.35
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Commercial |
$343.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Healthscope Commercial |
$354.78
|
| Rate for Payer: Healthscope Whirlpool |
$365.75
|
| Rate for Payer: Mclaren Commercial |
$329.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: Nomi Health Commercial |
$299.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.86
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$306.69
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$79.49 |
| Max. Negotiated Rate |
$306.69 |
| Rate for Payer: Aetna Commercial |
$276.02
|
| Rate for Payer: Aetna Medicare |
$151.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: ASR ASR |
$297.49
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$252.87
|
| Rate for Payer: BCN Commercial |
$252.87
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$288.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$297.49
|
| Rate for Payer: Healthscope Whirlpool |
$306.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.99
|
| Rate for Payer: Mclaren Commercial |
$276.02
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$83.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.69
|
| Rate for Payer: Nomi Health Commercial |
$251.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.02
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$167.19
|
| Rate for Payer: PHP Medicaid |
$81.47
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$268.72
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health Narrow Network |
$214.99
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$235.58
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP DNSP |
$151.99
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: VA VA |
$151.99
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$306.69
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$230.02 |
| Max. Negotiated Rate |
$306.69 |
| Rate for Payer: Aetna Commercial |
$276.02
|
| Rate for Payer: ASR ASR |
$297.49
|
| Rate for Payer: BCBS Trust/PPO |
$251.85
|
| Rate for Payer: BCN Commercial |
$251.85
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$288.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.35
|
| Rate for Payer: Healthscope Commercial |
$297.49
|
| Rate for Payer: Healthscope Whirlpool |
$306.69
|
| Rate for Payer: Mclaren Commercial |
$276.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.69
|
| Rate for Payer: Nomi Health Commercial |
$251.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.89
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$83.31
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$62.48 |
| Max. Negotiated Rate |
$83.31 |
| Rate for Payer: Aetna Commercial |
$74.98
|
| Rate for Payer: ASR ASR |
$80.81
|
| Rate for Payer: BCBS Trust/PPO |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.65
|
| Rate for Payer: Healthscope Commercial |
$80.81
|
| Rate for Payer: Healthscope Whirlpool |
$83.31
|
| Rate for Payer: Mclaren Commercial |
$74.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.81
|
| Rate for Payer: Nomi Health Commercial |
$68.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.31
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$83.31
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$235.58 |
| Rate for Payer: Aetna Commercial |
$74.98
|
| Rate for Payer: Aetna Medicare |
$151.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: ASR ASR |
$80.81
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$68.69
|
| Rate for Payer: BCN Commercial |
$68.69
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$80.81
|
| Rate for Payer: Healthscope Whirlpool |
$83.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.99
|
| Rate for Payer: Mclaren Commercial |
$74.98
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$83.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.81
|
| Rate for Payer: Nomi Health Commercial |
$68.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.48
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$167.19
|
| Rate for Payer: PHP Medicaid |
$81.47
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$73.00
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health Narrow Network |
$58.40
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$235.58
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP DNSP |
$151.99
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: VA VA |
$151.99
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$105.72
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$79.29 |
| Max. Negotiated Rate |
$105.72 |
| Rate for Payer: Aetna Commercial |
$95.15
|
| Rate for Payer: ASR ASR |
$102.55
|
| Rate for Payer: BCBS Trust/PPO |
$86.82
|
| Rate for Payer: BCN Commercial |
$86.82
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cofinity Commercial |
$99.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.58
|
| Rate for Payer: Healthscope Commercial |
$102.55
|
| Rate for Payer: Healthscope Whirlpool |
$105.72
|
| Rate for Payer: Mclaren Commercial |
$95.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.86
|
| Rate for Payer: Nomi Health Commercial |
$86.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.03
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$105.72
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.11 |
| Max. Negotiated Rate |
$235.58 |
| Rate for Payer: Aetna Commercial |
$95.15
|
| Rate for Payer: Aetna Medicare |
$151.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: ASR ASR |
$102.55
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$87.17
|
| Rate for Payer: BCN Commercial |
$87.17
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cofinity Commercial |
$99.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$102.55
|
| Rate for Payer: Healthscope Whirlpool |
$105.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.99
|
| Rate for Payer: Mclaren Commercial |
$95.15
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$83.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.86
|
| Rate for Payer: Nomi Health Commercial |
$86.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.29
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$167.19
|
| Rate for Payer: PHP Medicaid |
$81.47
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92.63
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health Narrow Network |
$74.11
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$235.58
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP DNSP |
$151.99
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: VA VA |
$151.99
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$22.72
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$65.38 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: Aetna Medicare |
$2.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.74
|
| Rate for Payer: ASR ASR |
$22.04
|
| Rate for Payer: BCBS Complete |
$1.64
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCBS Trust/PPO |
$18.73
|
| Rate for Payer: BCN Commercial |
$18.73
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$22.04
|
| Rate for Payer: Healthscope Whirlpool |
$22.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.99
|
| Rate for Payer: Mclaren Commercial |
$20.45
|
| Rate for Payer: Mclaren Medicaid |
$2.99
|
| Rate for Payer: Mclaren Medicare |
$2.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: Meridian Medicaid |
$1.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Nomi Health Commercial |
$18.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: PACE Medicare |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: PHP Medicaid |
$1.60
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Medicare |
$2.99
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.99
|
| Rate for Payer: UHC Exchange |
$4.63
|
| Rate for Payer: UHC Medicaid |
$1.56
|
| Rate for Payer: UHCCP DNSP |
$2.99
|
| Rate for Payer: UHCCP Medicaid |
$1.56
|
| Rate for Payer: VA VA |
$2.99
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$22.72
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$22.72 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: ASR ASR |
$22.04
|
| Rate for Payer: BCBS Trust/PPO |
$18.66
|
| Rate for Payer: BCN Commercial |
$18.66
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Healthscope Commercial |
$22.04
|
| Rate for Payer: Healthscope Whirlpool |
$22.72
|
| Rate for Payer: Mclaren Commercial |
$20.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Nomi Health Commercial |
$18.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.99
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,170.45 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,404.54
|
| Rate for Payer: ASR ASR |
$1,513.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,281.56
|
| Rate for Payer: BCN Commercial |
$1,281.56
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,466.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,513.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,560.60
|
| Rate for Payer: Mclaren Commercial |
$1,404.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.33
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$96.83 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,404.54
|
| Rate for Payer: Aetna Medicare |
$185.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.44
|
| Rate for Payer: ASR ASR |
$1,513.78
|
| Rate for Payer: BCBS Complete |
$101.68
|
| Rate for Payer: BCBS MAPPO |
$185.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.71
|
| Rate for Payer: BCN Commercial |
$1,286.71
|
| Rate for Payer: BCN Medicare Advantage |
$185.15
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,466.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.15
|
| Rate for Payer: Healthscope Commercial |
$1,513.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,560.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$185.15
|
| Rate for Payer: Mclaren Commercial |
$1,404.54
|
| Rate for Payer: Mclaren Medicaid |
$185.15
|
| Rate for Payer: Mclaren Medicare |
$185.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.41
|
| Rate for Payer: Meridian Medicaid |
$101.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PACE Medicare |
$175.89
|
| Rate for Payer: PACE SWMI |
$185.15
|
| Rate for Payer: PHP Commercial |
$203.66
|
| Rate for Payer: PHP Medicaid |
$99.24
|
| Rate for Payer: PHP Medicare Advantage |
$185.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$491.48
|
| Rate for Payer: Priority Health Medicare |
$185.15
|
| Rate for Payer: Priority Health Narrow Network |
$393.19
|
| Rate for Payer: Railroad Medicare Medicare |
$185.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.15
|
| Rate for Payer: UHC Exchange |
$286.98
|
| Rate for Payer: UHC Medicaid |
$96.83
|
| Rate for Payer: UHCCP DNSP |
$185.15
|
| Rate for Payer: UHCCP Medicaid |
$96.83
|
| Rate for Payer: VA VA |
$185.15
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$234.83 |
| Rate for Payer: Aetna Commercial |
$141.57
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: ASR ASR |
$152.58
|
| Rate for Payer: BCBS Complete |
$21.56
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$129.69
|
| Rate for Payer: BCN Commercial |
$129.69
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Commercial |
$147.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$152.58
|
| Rate for Payer: Healthscope Whirlpool |
$157.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$39.26
|
| Rate for Payer: Mclaren Commercial |
$141.57
|
| Rate for Payer: Mclaren Medicaid |
$39.26
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$21.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$43.19
|
| Rate for Payer: PHP Medicaid |
$21.04
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$234.83
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.26
|
| Rate for Payer: UHC Exchange |
$60.85
|
| Rate for Payer: UHC Medicaid |
$20.53
|
| Rate for Payer: UHCCP DNSP |
$39.26
|
| Rate for Payer: UHCCP Medicaid |
$20.53
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$117.97 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Aetna Commercial |
$141.57
|
| Rate for Payer: ASR ASR |
$152.58
|
| Rate for Payer: BCBS Trust/PPO |
$129.17
|
| Rate for Payer: BCN Commercial |
$129.17
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Commercial |
$147.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$152.58
|
| Rate for Payer: Healthscope Whirlpool |
$157.30
|
| Rate for Payer: Mclaren Commercial |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.42
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,557.11 |
| Max. Negotiated Rate |
$2,076.14 |
| Rate for Payer: Aetna Commercial |
$1,868.53
|
| Rate for Payer: ASR ASR |
$2,013.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.93
|
| Rate for Payer: BCN Commercial |
$1,704.93
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Commercial |
$1,951.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$2,013.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,076.14
|
| Rate for Payer: Mclaren Commercial |
$1,868.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Nomi Health Commercial |
$1,702.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,827.00
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$768.17 |
| Max. Negotiated Rate |
$2,076.14 |
| Rate for Payer: Aetna Commercial |
$1,868.53
|
| Rate for Payer: Aetna Medicare |
$768.17
|
| Rate for Payer: ASR ASR |
$2,013.86
|
| Rate for Payer: BCBS Complete |
$830.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Commercial |
$1,951.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$2,013.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,076.14
|
| Rate for Payer: Mclaren Commercial |
$1,868.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,660.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Nomi Health Commercial |
$1,702.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,819.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,455.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,827.00
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,990.14
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$2,144.93
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,823.19
|
| Rate for Payer: BCN Commercial |
$1,823.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Commercial |
$2,078.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,144.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,211.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,990.14
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Nomi Health Commercial |
$1,813.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,937.51
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,945.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,658.45 |
| Max. Negotiated Rate |
$2,211.27 |
| Rate for Payer: Aetna Commercial |
$1,990.14
|
| Rate for Payer: ASR ASR |
$2,144.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.89
|
| Rate for Payer: BCN Commercial |
$1,815.89
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Commercial |
$2,078.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Healthscope Commercial |
$2,144.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,211.27
|
| Rate for Payer: Mclaren Commercial |
$1,990.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Nomi Health Commercial |
$1,813.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,945.92
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,579.47 |
| Max. Negotiated Rate |
$2,105.96 |
| Rate for Payer: Aetna Commercial |
$1,895.36
|
| Rate for Payer: ASR ASR |
$2,042.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.41
|
| Rate for Payer: BCN Commercial |
$1,729.41
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Commercial |
$1,979.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Healthscope Commercial |
$2,042.78
|
| Rate for Payer: Healthscope Whirlpool |
$2,105.96
|
| Rate for Payer: Mclaren Commercial |
$1,895.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Nomi Health Commercial |
$1,726.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,853.24
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.74 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,895.36
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$2,042.78
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,736.36
|
| Rate for Payer: BCN Commercial |
$1,736.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Commercial |
$1,979.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,042.78
|
| Rate for Payer: Healthscope Whirlpool |
$2,105.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,895.36
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Nomi Health Commercial |
$1,726.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$623.43
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$498.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,853.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,912.86 |
| Max. Negotiated Rate |
$2,550.48 |
| Rate for Payer: Aetna Commercial |
$2,295.43
|
| Rate for Payer: ASR ASR |
$2,473.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.45
|
| Rate for Payer: BCN Commercial |
$2,094.45
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,397.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,473.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,550.48
|
| Rate for Payer: Mclaren Commercial |
$2,295.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.42
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,361.15 |
| Max. Negotiated Rate |
$4,486.12 |
| Rate for Payer: Aetna Commercial |
$2,295.43
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$2,473.97
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.87
|
| Rate for Payer: BCN Commercial |
$2,102.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,397.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,473.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,550.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$2,295.43
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,701.44
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$139.02 |
| Max. Negotiated Rate |
$1,244.31 |
| Rate for Payer: Aetna Commercial |
$178.49
|
| Rate for Payer: Aetna Medicare |
$802.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: ASR ASR |
$192.37
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$163.51
|
| Rate for Payer: BCN Commercial |
$163.51
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Commercial |
$186.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$192.37
|
| Rate for Payer: Healthscope Whirlpool |
$198.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$802.78
|
| Rate for Payer: Mclaren Commercial |
$178.49
|
| Rate for Payer: Mclaren Medicaid |
$802.78
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$440.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$162.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$883.06
|
| Rate for Payer: PHP Medicaid |
$430.29
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$173.77
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health Narrow Network |
$139.02
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,244.31
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP DNSP |
$802.78
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: VA VA |
$802.78
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$148.74 |
| Max. Negotiated Rate |
$198.32 |
| Rate for Payer: Aetna Commercial |
$178.49
|
| Rate for Payer: ASR ASR |
$192.37
|
| Rate for Payer: BCBS Trust/PPO |
$162.86
|
| Rate for Payer: BCN Commercial |
$162.86
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Commercial |
$186.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$192.37
|
| Rate for Payer: Healthscope Whirlpool |
$198.32
|
| Rate for Payer: Mclaren Commercial |
$178.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$162.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.52
|
|
