|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.30 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: ASR ASR |
$101.93
|
| Rate for Payer: ASR Commercial |
$101.93
|
| Rate for Payer: BCBS Trust/PPO |
$85.63
|
| Rate for Payer: BCN Commercial |
$81.47
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$98.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Healthscope Whirlpool |
$101.93
|
| Rate for Payer: Mclaren Commercial |
$94.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.47
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$101.93
|
| Rate for Payer: ASR Commercial |
$101.93
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$86.05
|
| Rate for Payer: BCN Commercial |
$81.47
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$98.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Healthscope Whirlpool |
$101.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$94.57
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.07
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$73.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$79.34 |
| Rate for Payer: Aetna Commercial |
$70.08
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$75.53
|
| Rate for Payer: ASR Commercial |
$75.53
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.77
|
| Rate for Payer: BCN Commercial |
$60.37
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$73.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$77.87
|
| Rate for Payer: Healthscope Whirlpool |
$75.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$70.08
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.23
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$54.59
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$77.87 |
| Rate for Payer: Aetna Commercial |
$70.08
|
| Rate for Payer: ASR ASR |
$75.53
|
| Rate for Payer: ASR Commercial |
$75.53
|
| Rate for Payer: BCBS Trust/PPO |
$63.46
|
| Rate for Payer: BCN Commercial |
$60.37
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$73.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$77.87
|
| Rate for Payer: Healthscope Whirlpool |
$75.53
|
| Rate for Payer: Mclaren Commercial |
$70.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.53
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.88 |
| Max. Negotiated Rate |
$390.15 |
| Rate for Payer: Aetna Commercial |
$351.13
|
| Rate for Payer: Aetna Medicare |
$163.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: ASR ASR |
$378.45
|
| Rate for Payer: ASR Commercial |
$378.45
|
| Rate for Payer: BCBS Complete |
$92.28
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$319.49
|
| Rate for Payer: BCN Commercial |
$302.48
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$366.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$390.15
|
| Rate for Payer: Healthscope Whirlpool |
$378.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.96
|
| Rate for Payer: Mclaren Commercial |
$351.13
|
| Rate for Payer: Mclaren Medicaid |
$87.88
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$92.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$180.36
|
| Rate for Payer: PHP Medicaid |
$87.88
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.85
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health Narrow Network |
$273.50
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.96
|
| Rate for Payer: UHC Exchange |
$254.14
|
| Rate for Payer: UHC Medicare Advantage |
$163.96
|
| Rate for Payer: UHCCP DNSP |
$163.96
|
| Rate for Payer: UHCCP Medicaid |
$87.88
|
| Rate for Payer: VA VA |
$163.96
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$253.60 |
| Max. Negotiated Rate |
$390.15 |
| Rate for Payer: Aetna Commercial |
$351.13
|
| Rate for Payer: ASR ASR |
$378.45
|
| Rate for Payer: ASR Commercial |
$378.45
|
| Rate for Payer: BCBS Trust/PPO |
$317.93
|
| Rate for Payer: BCN Commercial |
$302.48
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$366.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$390.15
|
| Rate for Payer: Healthscope Whirlpool |
$378.45
|
| Rate for Payer: Mclaren Commercial |
$351.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.33
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$236.92
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.63 |
| Max. Negotiated Rate |
$236.92 |
| Rate for Payer: Aetna Commercial |
$213.23
|
| Rate for Payer: Aetna Medicare |
$144.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.05
|
| Rate for Payer: ASR ASR |
$229.81
|
| Rate for Payer: ASR Commercial |
$229.81
|
| Rate for Payer: BCBS Complete |
$81.52
|
| Rate for Payer: BCBS MAPPO |
$144.84
|
| Rate for Payer: BCBS Trust/PPO |
$194.01
|
| Rate for Payer: BCN Commercial |
$183.68
|
| Rate for Payer: BCN Medicare Advantage |
$144.84
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cofinity Commercial |
$222.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.84
|
| Rate for Payer: Healthscope Commercial |
$236.92
|
| Rate for Payer: Healthscope Whirlpool |
$229.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$144.84
|
| Rate for Payer: Mclaren Commercial |
$213.23
|
| Rate for Payer: Mclaren Medicaid |
$77.63
|
| Rate for Payer: Mclaren Medicare |
$144.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.08
|
| Rate for Payer: Meridian Medicaid |
$81.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.38
|
| Rate for Payer: Nomi Health Commercial |
$194.27
|
| Rate for Payer: PACE Medicare |
$137.60
|
| Rate for Payer: PACE SWMI |
$144.84
|
| Rate for Payer: PHP Commercial |
$159.32
|
| Rate for Payer: PHP Medicaid |
$77.63
|
| Rate for Payer: PHP Medicare Advantage |
$144.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.59
|
| Rate for Payer: Priority Health Medicare |
$144.84
|
| Rate for Payer: Priority Health Narrow Network |
$166.08
|
| Rate for Payer: Railroad Medicare Medicare |
$144.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.84
|
| Rate for Payer: UHC Exchange |
$224.50
|
| Rate for Payer: UHC Medicare Advantage |
$144.84
|
| Rate for Payer: UHCCP DNSP |
$144.84
|
| Rate for Payer: UHCCP Medicaid |
$77.63
|
| Rate for Payer: VA VA |
$144.84
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$236.92
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$236.92 |
| Rate for Payer: Aetna Commercial |
$213.23
|
| Rate for Payer: ASR ASR |
$229.81
|
| Rate for Payer: ASR Commercial |
$229.81
|
| Rate for Payer: BCBS Trust/PPO |
$193.07
|
| Rate for Payer: BCN Commercial |
$183.68
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cofinity Commercial |
$222.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.54
|
| Rate for Payer: Healthscope Commercial |
$236.92
|
| Rate for Payer: Healthscope Whirlpool |
$229.81
|
| Rate for Payer: Mclaren Commercial |
$213.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.38
|
| Rate for Payer: Nomi Health Commercial |
$194.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.49
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$351.08
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$228.20 |
| Max. Negotiated Rate |
$351.08 |
| Rate for Payer: Aetna Commercial |
$315.97
|
| Rate for Payer: ASR ASR |
$340.55
|
| Rate for Payer: ASR Commercial |
$340.55
|
| Rate for Payer: BCBS Trust/PPO |
$286.10
|
| Rate for Payer: BCN Commercial |
$272.19
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.86
|
| Rate for Payer: Healthscope Commercial |
$351.08
|
| Rate for Payer: Healthscope Whirlpool |
$340.55
|
| Rate for Payer: Mclaren Commercial |
$315.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.42
|
| Rate for Payer: Nomi Health Commercial |
$287.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.95
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$351.08
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$115.04 |
| Max. Negotiated Rate |
$351.08 |
| Rate for Payer: Aetna Commercial |
$315.97
|
| Rate for Payer: Aetna Medicare |
$214.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.27
|
| Rate for Payer: ASR ASR |
$340.55
|
| Rate for Payer: ASR Commercial |
$340.55
|
| Rate for Payer: BCBS Complete |
$120.79
|
| Rate for Payer: BCBS MAPPO |
$214.62
|
| Rate for Payer: BCBS Trust/PPO |
$287.50
|
| Rate for Payer: BCN Commercial |
$272.19
|
| Rate for Payer: BCN Medicare Advantage |
$214.62
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.62
|
| Rate for Payer: Healthscope Commercial |
$351.08
|
| Rate for Payer: Healthscope Whirlpool |
$340.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$214.62
|
| Rate for Payer: Mclaren Commercial |
$315.97
|
| Rate for Payer: Mclaren Medicaid |
$115.04
|
| Rate for Payer: Mclaren Medicare |
$214.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.35
|
| Rate for Payer: Meridian Medicaid |
$120.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.42
|
| Rate for Payer: Nomi Health Commercial |
$287.89
|
| Rate for Payer: PACE Medicare |
$203.89
|
| Rate for Payer: PACE SWMI |
$214.62
|
| Rate for Payer: PHP Commercial |
$236.08
|
| Rate for Payer: PHP Medicaid |
$115.04
|
| Rate for Payer: PHP Medicare Advantage |
$214.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.62
|
| Rate for Payer: Priority Health Medicare |
$214.62
|
| Rate for Payer: Priority Health Narrow Network |
$246.11
|
| Rate for Payer: Railroad Medicare Medicare |
$214.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.62
|
| Rate for Payer: UHC Exchange |
$332.66
|
| Rate for Payer: UHC Medicare Advantage |
$214.62
|
| Rate for Payer: UHCCP DNSP |
$214.62
|
| Rate for Payer: UHCCP Medicaid |
$115.04
|
| Rate for Payer: VA VA |
$214.62
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$268.20
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.88 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna Medicare |
$163.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: ASR ASR |
$260.15
|
| Rate for Payer: ASR Commercial |
$260.15
|
| Rate for Payer: BCBS Complete |
$92.28
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$219.63
|
| Rate for Payer: BCN Commercial |
$207.94
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cofinity Commercial |
$252.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$268.20
|
| Rate for Payer: Healthscope Whirlpool |
$260.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.96
|
| Rate for Payer: Mclaren Commercial |
$241.38
|
| Rate for Payer: Mclaren Medicaid |
$87.88
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$92.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.97
|
| Rate for Payer: Nomi Health Commercial |
$219.92
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$180.36
|
| Rate for Payer: PHP Medicaid |
$87.88
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.00
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health Narrow Network |
$188.01
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.96
|
| Rate for Payer: UHC Exchange |
$254.14
|
| Rate for Payer: UHC Medicare Advantage |
$163.96
|
| Rate for Payer: UHCCP DNSP |
$163.96
|
| Rate for Payer: UHCCP Medicaid |
$87.88
|
| Rate for Payer: VA VA |
$163.96
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$268.20
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.33 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: ASR ASR |
$260.15
|
| Rate for Payer: ASR Commercial |
$260.15
|
| Rate for Payer: BCBS Trust/PPO |
$218.56
|
| Rate for Payer: BCN Commercial |
$207.94
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cofinity Commercial |
$252.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.56
|
| Rate for Payer: Healthscope Commercial |
$268.20
|
| Rate for Payer: Healthscope Whirlpool |
$260.15
|
| Rate for Payer: Mclaren Commercial |
$241.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.97
|
| Rate for Payer: Nomi Health Commercial |
$219.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.02
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$6.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$3.38
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.01
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$3.22
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: Meridian Medicaid |
$3.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$6.61
|
| Rate for Payer: PHP Medicaid |
$3.22
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Exchange |
$9.32
|
| Rate for Payer: UHC Medicare Advantage |
$6.01
|
| Rate for Payer: UHCCP DNSP |
$6.01
|
| Rate for Payer: UHCCP Medicaid |
$3.22
|
| Rate for Payer: VA VA |
$6.01
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$40.32
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.21 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna Commercial |
$36.29
|
| Rate for Payer: ASR ASR |
$39.11
|
| Rate for Payer: ASR Commercial |
$39.11
|
| Rate for Payer: BCBS Trust/PPO |
$32.86
|
| Rate for Payer: BCN Commercial |
$31.26
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$37.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Healthscope Whirlpool |
$39.11
|
| Rate for Payer: Mclaren Commercial |
$36.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.27
|
| Rate for Payer: Nomi Health Commercial |
$33.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.48
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$40.32
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna Commercial |
$36.29
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: ASR ASR |
$39.11
|
| Rate for Payer: ASR Commercial |
$39.11
|
| Rate for Payer: BCBS Complete |
$5.73
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$33.02
|
| Rate for Payer: BCN Commercial |
$31.26
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$37.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Healthscope Whirlpool |
$39.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.18
|
| Rate for Payer: Mclaren Commercial |
$36.29
|
| Rate for Payer: Mclaren Medicaid |
$5.46
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: Meridian Medicaid |
$5.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.27
|
| Rate for Payer: Nomi Health Commercial |
$33.06
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$11.20
|
| Rate for Payer: PHP Medicaid |
$5.46
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.33
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow Network |
$28.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.18
|
| Rate for Payer: UHC Exchange |
$15.78
|
| Rate for Payer: UHC Medicare Advantage |
$10.18
|
| Rate for Payer: UHCCP DNSP |
$10.18
|
| Rate for Payer: UHCCP Medicaid |
$5.46
|
| Rate for Payer: VA VA |
$10.18
|
|
|
HC BDIAL F8A
|
Facility
|
IP
|
$66.95
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.52 |
| Max. Negotiated Rate |
$66.95 |
| Rate for Payer: Aetna Commercial |
$60.26
|
| Rate for Payer: ASR ASR |
$64.94
|
| Rate for Payer: ASR Commercial |
$64.94
|
| Rate for Payer: BCBS Trust/PPO |
$54.56
|
| Rate for Payer: BCN Commercial |
$51.91
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cofinity Commercial |
$62.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.56
|
| Rate for Payer: Healthscope Commercial |
$66.95
|
| Rate for Payer: Healthscope Whirlpool |
$64.94
|
| Rate for Payer: Mclaren Commercial |
$60.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.91
|
| Rate for Payer: Nomi Health Commercial |
$54.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.92
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$66.95
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$66.95 |
| Rate for Payer: Aetna Commercial |
$60.26
|
| Rate for Payer: Aetna Medicare |
$17.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: ASR ASR |
$64.94
|
| Rate for Payer: ASR Commercial |
$64.94
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$54.83
|
| Rate for Payer: BCN Commercial |
$51.91
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cofinity Commercial |
$62.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$66.95
|
| Rate for Payer: Healthscope Whirlpool |
$64.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.90
|
| Rate for Payer: Mclaren Commercial |
$60.26
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.91
|
| Rate for Payer: Nomi Health Commercial |
$54.90
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$19.69
|
| Rate for Payer: PHP Medicaid |
$9.59
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.66
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$46.93
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$27.75
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP DNSP |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC BDIAL FIBC
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$35.37 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: ASR ASR |
$34.31
|
| Rate for Payer: ASR Commercial |
$34.31
|
| Rate for Payer: BCBS Trust/PPO |
$28.82
|
| Rate for Payer: BCN Commercial |
$27.42
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$35.37
|
| Rate for Payer: Healthscope Whirlpool |
$34.31
|
| Rate for Payer: Mclaren Commercial |
$31.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
|
|
HC BDIAL FIBC
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$35.37 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$9.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.15
|
| Rate for Payer: ASR ASR |
$34.31
|
| Rate for Payer: ASR Commercial |
$34.31
|
| Rate for Payer: BCBS Complete |
$5.47
|
| Rate for Payer: BCBS MAPPO |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$28.96
|
| Rate for Payer: BCN Commercial |
$27.42
|
| Rate for Payer: BCN Medicare Advantage |
$9.72
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$35.37
|
| Rate for Payer: Healthscope Whirlpool |
$34.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.72
|
| Rate for Payer: Mclaren Commercial |
$31.83
|
| Rate for Payer: Mclaren Medicaid |
$5.21
|
| Rate for Payer: Mclaren Medicare |
$9.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.21
|
| Rate for Payer: Meridian Medicaid |
$5.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Medicare |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.72
|
| Rate for Payer: PHP Commercial |
$10.69
|
| Rate for Payer: PHP Medicaid |
$5.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.99
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health Narrow Network |
$24.79
|
| Rate for Payer: Railroad Medicare Medicare |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.72
|
| Rate for Payer: UHC Exchange |
$15.07
|
| Rate for Payer: UHC Medicare Advantage |
$9.72
|
| Rate for Payer: UHCCP DNSP |
$9.72
|
| Rate for Payer: UHCCP Medicaid |
$5.21
|
| Rate for Payer: VA VA |
$9.72
|
|
|
HC BDIAL FXIII
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
|
HC BDIAL FXIII
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: Aetna Medicare |
$9.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.39
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$9.11
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.11
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Mclaren Medicare |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.57
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Medicare |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.11
|
| Rate for Payer: PHP Commercial |
$10.02
|
| Rate for Payer: PHP Medicaid |
$4.88
|
| Rate for Payer: PHP Medicare Advantage |
$9.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.82
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health Narrow Network |
$24.65
|
| Rate for Payer: Railroad Medicare Medicare |
$9.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.11
|
| Rate for Payer: UHC Exchange |
$14.12
|
| Rate for Payer: UHC Medicare Advantage |
$9.11
|
| Rate for Payer: UHCCP DNSP |
$9.11
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: VA VA |
$9.11
|
|
|
HC BDIAL PTIN
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.74
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC BDIAL PTIN
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$4.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.29
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$2.30
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$4.72
|
| Rate for Payer: PHP Medicaid |
$2.30
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.52
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow Network |
$20.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.29
|
| Rate for Payer: UHC Exchange |
$6.65
|
| Rate for Payer: UHC Medicare Advantage |
$4.29
|
| Rate for Payer: UHCCP DNSP |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$2.30
|
| Rate for Payer: VA VA |
$4.29
|
|
|
HC BDIAL SFM
|
Facility
|
OP
|
$249.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.13 |
| Max. Negotiated Rate |
$249.98 |
| Rate for Payer: Aetna Commercial |
$224.98
|
| Rate for Payer: Aetna Medicare |
$80.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.58
|
| Rate for Payer: ASR ASR |
$242.48
|
| Rate for Payer: ASR Commercial |
$242.48
|
| Rate for Payer: BCBS Complete |
$45.28
|
| Rate for Payer: BCBS MAPPO |
$80.46
|
| Rate for Payer: BCBS Trust/PPO |
$204.71
|
| Rate for Payer: BCN Commercial |
$193.81
|
| Rate for Payer: BCN Medicare Advantage |
$80.46
|
| Rate for Payer: Cash Price |
$199.98
|
| Rate for Payer: Cash Price |
$199.98
|
| Rate for Payer: Cofinity Commercial |
$234.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.46
|
| Rate for Payer: Healthscope Commercial |
$249.98
|
| Rate for Payer: Healthscope Whirlpool |
$242.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.46
|
| Rate for Payer: Mclaren Commercial |
$224.98
|
| Rate for Payer: Mclaren Medicaid |
$43.13
|
| Rate for Payer: Mclaren Medicare |
$80.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.48
|
| Rate for Payer: Meridian Medicaid |
$45.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.48
|
| Rate for Payer: Nomi Health Commercial |
$204.98
|
| Rate for Payer: PACE Medicare |
$76.44
|
| Rate for Payer: PACE SWMI |
$80.46
|
| Rate for Payer: PHP Commercial |
$88.51
|
| Rate for Payer: PHP Medicaid |
$43.13
|
| Rate for Payer: PHP Medicare Advantage |
$80.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.03
|
| Rate for Payer: Priority Health Medicare |
$80.46
|
| Rate for Payer: Priority Health Narrow Network |
$175.24
|
| Rate for Payer: Railroad Medicare Medicare |
$80.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.46
|
| Rate for Payer: UHC Exchange |
$124.71
|
| Rate for Payer: UHC Medicare Advantage |
$80.46
|
| Rate for Payer: UHCCP DNSP |
$80.46
|
| Rate for Payer: UHCCP Medicaid |
$43.13
|
| Rate for Payer: VA VA |
$80.46
|
|
