|
HC ANTI FACTOR XA
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC ANTI FACTOR XA
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$13.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.09
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Mclaren Medicare |
$13.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$14.40
|
| Rate for Payer: PHP Medicaid |
$7.02
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$13.09
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.09
|
| Rate for Payer: UHC Exchange |
$20.29
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
| Rate for Payer: UHCCP DNSP |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: VA VA |
$13.09
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$113.82 |
| Rate for Payer: Aetna Commercial |
$102.44
|
| Rate for Payer: ASR ASR |
$110.41
|
| Rate for Payer: ASR Commercial |
$110.41
|
| Rate for Payer: BCBS Trust/PPO |
$92.75
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$113.82
|
| Rate for Payer: Healthscope Whirlpool |
$110.41
|
| Rate for Payer: Mclaren Commercial |
$102.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.16
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Aetna Commercial |
$102.44
|
| Rate for Payer: Aetna Medicare |
$352.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: ASR ASR |
$110.41
|
| Rate for Payer: ASR Commercial |
$110.41
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$93.21
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$113.82
|
| Rate for Payer: Healthscope Whirlpool |
$110.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$352.45
|
| Rate for Payer: Mclaren Commercial |
$102.44
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$387.70
|
| Rate for Payer: PHP Medicaid |
$188.91
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.73
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$79.79
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$546.30
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP DNSP |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: VA VA |
$352.45
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$113.82 |
| Rate for Payer: Aetna Commercial |
$102.44
|
| Rate for Payer: ASR ASR |
$110.41
|
| Rate for Payer: ASR Commercial |
$110.41
|
| Rate for Payer: BCBS Trust/PPO |
$92.75
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$113.82
|
| Rate for Payer: Healthscope Whirlpool |
$110.41
|
| Rate for Payer: Mclaren Commercial |
$102.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.16
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Aetna Commercial |
$102.44
|
| Rate for Payer: Aetna Medicare |
$352.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: ASR ASR |
$110.41
|
| Rate for Payer: ASR Commercial |
$110.41
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$93.21
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$113.82
|
| Rate for Payer: Healthscope Whirlpool |
$110.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$352.45
|
| Rate for Payer: Mclaren Commercial |
$102.44
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$387.70
|
| Rate for Payer: PHP Medicaid |
$188.91
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.73
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$79.79
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$546.30
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP DNSP |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: VA VA |
$352.45
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Aetna Commercial |
$102.44
|
| Rate for Payer: Aetna Medicare |
$352.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: ASR ASR |
$110.41
|
| Rate for Payer: ASR Commercial |
$110.41
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$93.21
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$113.82
|
| Rate for Payer: Healthscope Whirlpool |
$110.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$352.45
|
| Rate for Payer: Mclaren Commercial |
$102.44
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$387.70
|
| Rate for Payer: PHP Medicaid |
$188.91
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.73
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$79.79
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$546.30
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP DNSP |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: VA VA |
$352.45
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$113.82 |
| Rate for Payer: Aetna Commercial |
$102.44
|
| Rate for Payer: ASR ASR |
$110.41
|
| Rate for Payer: ASR Commercial |
$110.41
|
| Rate for Payer: BCBS Trust/PPO |
$92.75
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$113.82
|
| Rate for Payer: Healthscope Whirlpool |
$110.41
|
| Rate for Payer: Mclaren Commercial |
$102.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.16
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Trust/PPO |
$46.63
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$312.93 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$46.86
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.93
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$250.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$37.45 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: ASR ASR |
$36.33
|
| Rate for Payer: ASR Commercial |
$36.33
|
| Rate for Payer: BCBS Trust/PPO |
$30.52
|
| Rate for Payer: BCN Commercial |
$29.03
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$35.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$37.45
|
| Rate for Payer: Healthscope Whirlpool |
$36.33
|
| Rate for Payer: Mclaren Commercial |
$33.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.96
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$210.82 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$36.33
|
| Rate for Payer: ASR Commercial |
$36.33
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$30.67
|
| Rate for Payer: BCN Commercial |
$29.03
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$35.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$37.45
|
| Rate for Payer: Healthscope Whirlpool |
$36.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$33.70
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$123.42
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.22 |
| Max. Negotiated Rate |
$123.42 |
| Rate for Payer: Aetna Commercial |
$111.08
|
| Rate for Payer: ASR ASR |
$119.72
|
| Rate for Payer: ASR Commercial |
$119.72
|
| Rate for Payer: BCBS Trust/PPO |
$100.57
|
| Rate for Payer: BCN Commercial |
$95.69
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cofinity Commercial |
$116.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.74
|
| Rate for Payer: Healthscope Commercial |
$123.42
|
| Rate for Payer: Healthscope Whirlpool |
$119.72
|
| Rate for Payer: Mclaren Commercial |
$111.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.91
|
| Rate for Payer: Nomi Health Commercial |
$101.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.61
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$123.42
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$123.42 |
| Rate for Payer: Aetna Commercial |
$111.08
|
| Rate for Payer: Aetna Medicare |
$38.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.28
|
| Rate for Payer: ASR ASR |
$119.72
|
| Rate for Payer: ASR Commercial |
$119.72
|
| Rate for Payer: BCBS Complete |
$21.74
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$101.07
|
| Rate for Payer: BCN Commercial |
$95.69
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cofinity Commercial |
$116.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$123.42
|
| Rate for Payer: Healthscope Whirlpool |
$119.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.62
|
| Rate for Payer: Mclaren Commercial |
$111.08
|
| Rate for Payer: Mclaren Medicaid |
$20.70
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$21.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.91
|
| Rate for Payer: Nomi Health Commercial |
$101.20
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicaid |
$20.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.14
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health Narrow Network |
$86.52
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$59.86
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: UHCCP DNSP |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$20.70
|
| Rate for Payer: VA VA |
$38.62
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$72.10
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$64.89
|
| Rate for Payer: Aetna Medicare |
$13.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: ASR ASR |
$69.94
|
| Rate for Payer: ASR Commercial |
$69.94
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$59.04
|
| Rate for Payer: BCN Commercial |
$55.90
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$67.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Healthscope Whirlpool |
$69.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.74
|
| Rate for Payer: Mclaren Commercial |
$64.89
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$15.11
|
| Rate for Payer: PHP Medicaid |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.24
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health Narrow Network |
$28.99
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.74
|
| Rate for Payer: UHC Exchange |
$21.30
|
| Rate for Payer: UHC Medicare Advantage |
$13.74
|
| Rate for Payer: UHCCP DNSP |
$13.74
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$13.74
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$72.10
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$64.89
|
| Rate for Payer: ASR ASR |
$69.94
|
| Rate for Payer: ASR Commercial |
$69.94
|
| Rate for Payer: BCBS Trust/PPO |
$58.75
|
| Rate for Payer: BCN Commercial |
$55.90
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$67.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Healthscope Whirlpool |
$69.94
|
| Rate for Payer: Mclaren Commercial |
$64.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.45
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$72.10
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$64.89
|
| Rate for Payer: ASR ASR |
$69.94
|
| Rate for Payer: ASR Commercial |
$69.94
|
| Rate for Payer: BCBS Trust/PPO |
$58.75
|
| Rate for Payer: BCN Commercial |
$55.90
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$67.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Healthscope Whirlpool |
$69.94
|
| Rate for Payer: Mclaren Commercial |
$64.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.45
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$72.10
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$64.89
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$69.94
|
| Rate for Payer: ASR Commercial |
$69.94
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$59.04
|
| Rate for Payer: BCN Commercial |
$55.90
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$67.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Healthscope Whirlpool |
$69.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$64.89
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.74
|
| Rate for Payer: UHC Medicare Advantage |
$12.09
|
| Rate for Payer: UHCCP DNSP |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.48
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.15
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$38.34
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.74
|
| Rate for Payer: UHC Medicare Advantage |
$12.09
|
| Rate for Payer: UHCCP DNSP |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.48
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.98 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$11.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.95
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS MAPPO |
$11.16
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.16
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$5.98
|
| Rate for Payer: Mclaren Medicare |
$11.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.72
|
| Rate for Payer: Meridian Medicaid |
$6.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$10.60
|
| Rate for Payer: PACE SWMI |
$11.16
|
| Rate for Payer: PHP Commercial |
$12.28
|
| Rate for Payer: PHP Medicaid |
$5.98
|
| Rate for Payer: PHP Medicare Advantage |
$11.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.14
|
| Rate for Payer: Priority Health Medicare |
$11.16
|
| Rate for Payer: Priority Health Narrow Network |
$28.11
|
| Rate for Payer: Railroad Medicare Medicare |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.16
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicare Advantage |
$11.16
|
| Rate for Payer: UHCCP DNSP |
$11.16
|
| Rate for Payer: UHCCP Medicaid |
$5.98
|
| Rate for Payer: VA VA |
$11.16
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$50.87
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$51.12
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.69
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$43.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.08 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: ASR ASR |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.52
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
|
