|
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
|
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 |
$20.58
|
| 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 |
$27.74
|
| 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 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 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 |
$72.47 |
| 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 |
$72.47
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health Narrow Network |
$57.98
|
| 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 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 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 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 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 |
$25.81
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow Network |
$20.65
|
| 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 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 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
|
|
|
HC BDIAL SFM
|
Facility
|
IP
|
$249.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$162.49 |
| Max. Negotiated Rate |
$249.98 |
| Rate for Payer: Aetna Commercial |
$224.98
|
| Rate for Payer: ASR ASR |
$242.48
|
| Rate for Payer: ASR Commercial |
$242.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.71
|
| Rate for Payer: BCN Commercial |
$193.81
|
| 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: Healthscope Commercial |
$249.98
|
| Rate for Payer: Healthscope Whirlpool |
$242.48
|
| Rate for Payer: Mclaren Commercial |
$224.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.48
|
| Rate for Payer: Nomi Health Commercial |
$204.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.98
|
|
|
HC BDIAL TT
|
Facility
|
IP
|
$25.10
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$25.10 |
| Rate for Payer: Aetna Commercial |
$22.59
|
| Rate for Payer: ASR ASR |
$24.35
|
| Rate for Payer: ASR Commercial |
$24.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.45
|
| Rate for Payer: BCN Commercial |
$19.46
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Cofinity Commercial |
$23.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$25.10
|
| Rate for Payer: Healthscope Whirlpool |
$24.35
|
| Rate for Payer: Mclaren Commercial |
$22.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.34
|
| Rate for Payer: Nomi Health Commercial |
$20.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.09
|
|
|
HC BDIAL TT
|
Facility
|
OP
|
$25.10
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$25.10 |
| Rate for Payer: Aetna Commercial |
$22.59
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.21
|
| Rate for Payer: ASR ASR |
$24.35
|
| Rate for Payer: ASR Commercial |
$24.35
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS MAPPO |
$5.77
|
| Rate for Payer: BCBS Trust/PPO |
$20.55
|
| Rate for Payer: BCN Commercial |
$19.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.77
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Cofinity Commercial |
$23.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.77
|
| Rate for Payer: Healthscope Commercial |
$25.10
|
| Rate for Payer: Healthscope Whirlpool |
$24.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.77
|
| Rate for Payer: Mclaren Commercial |
$22.59
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Mclaren Medicare |
$5.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.06
|
| Rate for Payer: Meridian Medicaid |
$3.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.34
|
| Rate for Payer: Nomi Health Commercial |
$20.58
|
| Rate for Payer: PACE Medicare |
$5.48
|
| Rate for Payer: PACE SWMI |
$5.77
|
| Rate for Payer: PHP Commercial |
$6.35
|
| Rate for Payer: PHP Medicaid |
$3.09
|
| Rate for Payer: PHP Medicare Advantage |
$5.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.99
|
| Rate for Payer: Priority Health Medicare |
$5.77
|
| Rate for Payer: Priority Health Narrow Network |
$17.60
|
| Rate for Payer: Railroad Medicare Medicare |
$5.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.77
|
| Rate for Payer: UHC Exchange |
$8.94
|
| Rate for Payer: UHC Medicare Advantage |
$5.77
|
| Rate for Payer: UHCCP DNSP |
$5.77
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$5.77
|
|
|
HC BDIAL VWAG
|
Facility
|
IP
|
$84.33
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.81 |
| Max. Negotiated Rate |
$84.33 |
| Rate for Payer: Aetna Commercial |
$75.90
|
| Rate for Payer: ASR ASR |
$81.80
|
| Rate for Payer: ASR Commercial |
$81.80
|
| Rate for Payer: BCBS Trust/PPO |
$68.72
|
| Rate for Payer: BCN Commercial |
$65.38
|
| Rate for Payer: Cash Price |
$67.46
|
| Rate for Payer: Cofinity Commercial |
$79.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.46
|
| Rate for Payer: Healthscope Commercial |
$84.33
|
| Rate for Payer: Healthscope Whirlpool |
$81.80
|
| Rate for Payer: Mclaren Commercial |
$75.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.68
|
| Rate for Payer: Nomi Health Commercial |
$69.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.21
|
|
|
HC BDIAL VWAG
|
Facility
|
OP
|
$84.33
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$197.64 |
| Rate for Payer: Aetna Commercial |
$75.90
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$81.80
|
| Rate for Payer: ASR Commercial |
$81.80
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$69.06
|
| Rate for Payer: BCN Commercial |
$65.38
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$67.46
|
| Rate for Payer: Cash Price |
$67.46
|
| Rate for Payer: Cofinity Commercial |
$79.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$84.33
|
| Rate for Payer: Healthscope Whirlpool |
$81.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$75.90
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.68
|
| Rate for Payer: Nomi Health Commercial |
$69.15
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.64
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$158.11
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC BDIAL VWFX
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$101.00 |
| Rate for Payer: Aetna Commercial |
$90.90
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$97.97
|
| Rate for Payer: ASR Commercial |
$97.97
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$82.71
|
| Rate for Payer: BCN Commercial |
$78.31
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$94.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$101.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$90.90
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.85
|
| Rate for Payer: Nomi Health Commercial |
$82.82
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.50
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$70.80
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC BDIAL VWFX
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$65.65 |
| Max. Negotiated Rate |
$101.00 |
| Rate for Payer: Aetna Commercial |
$90.90
|
| Rate for Payer: ASR ASR |
$97.97
|
| Rate for Payer: ASR Commercial |
$97.97
|
| Rate for Payer: BCBS Trust/PPO |
$82.30
|
| Rate for Payer: BCN Commercial |
$78.31
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$94.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Healthscope Commercial |
$101.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.97
|
| Rate for Payer: Mclaren Commercial |
$90.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.85
|
| Rate for Payer: Nomi Health Commercial |
$82.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.88
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
IP
|
$239.25
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$155.51 |
| Max. Negotiated Rate |
$239.25 |
| Rate for Payer: Aetna Commercial |
$215.32
|
| Rate for Payer: ASR ASR |
$232.07
|
| Rate for Payer: ASR Commercial |
$232.07
|
| Rate for Payer: BCBS Trust/PPO |
$194.96
|
| Rate for Payer: BCN Commercial |
$185.49
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Cofinity Commercial |
$224.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.40
|
| Rate for Payer: Healthscope Commercial |
$239.25
|
| Rate for Payer: Healthscope Whirlpool |
$232.07
|
| Rate for Payer: Mclaren Commercial |
$215.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.36
|
| Rate for Payer: Nomi Health Commercial |
$196.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.54
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
OP
|
$239.25
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$239.25 |
| Rate for Payer: Aetna Commercial |
$215.32
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$232.07
|
| Rate for Payer: ASR Commercial |
$232.07
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$195.92
|
| Rate for Payer: BCN Commercial |
$185.49
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Cofinity Commercial |
$224.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$239.25
|
| Rate for Payer: Healthscope Whirlpool |
$232.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$215.32
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.36
|
| Rate for Payer: Nomi Health Commercial |
$196.18
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.52
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$121.22
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$32.93 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.76
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| 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 |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.61
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$4.61
|
| Rate for Payer: Mclaren Medicare |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Medicare |
$8.18
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Commercial |
$9.47
|
| Rate for Payer: PHP Medicaid |
$4.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.93
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$26.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Exchange |
$13.35
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
| Rate for Payer: UHCCP DNSP |
$8.61
|
| Rate for Payer: UHCCP Medicaid |
$4.61
|
| Rate for Payer: VA VA |
$8.61
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| 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 BEECH IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC BEECH IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
OP
|
$169.12
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.73 |
| Max. Negotiated Rate |
$169.12 |
| Rate for Payer: Aetna Commercial |
$152.21
|
| Rate for Payer: Aetna Medicare |
$29.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.69
|
| Rate for Payer: ASR ASR |
$164.05
|
| Rate for Payer: ASR Commercial |
$164.05
|
| Rate for Payer: BCBS Complete |
$16.52
|
| Rate for Payer: BCBS MAPPO |
$29.35
|
| Rate for Payer: BCBS Trust/PPO |
$138.49
|
| Rate for Payer: BCN Commercial |
$131.12
|
| Rate for Payer: BCN Medicare Advantage |
$29.35
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$158.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.35
|
| Rate for Payer: Healthscope Commercial |
$169.12
|
| Rate for Payer: Healthscope Whirlpool |
$164.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.35
|
| Rate for Payer: Mclaren Commercial |
$152.21
|
| Rate for Payer: Mclaren Medicaid |
$15.73
|
| Rate for Payer: Mclaren Medicare |
$29.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.82
|
| Rate for Payer: Meridian Medicaid |
$16.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$138.68
|
| Rate for Payer: PACE Medicare |
$27.88
|
| Rate for Payer: PACE SWMI |
$29.35
|
| Rate for Payer: PHP Commercial |
$32.28
|
| Rate for Payer: PHP Medicaid |
$15.73
|
| Rate for Payer: PHP Medicare Advantage |
$29.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.55
|
| Rate for Payer: Priority Health Medicare |
$29.35
|
| Rate for Payer: Priority Health Narrow Network |
$67.64
|
| Rate for Payer: Railroad Medicare Medicare |
$29.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.35
|
| Rate for Payer: UHC Exchange |
$45.49
|
| Rate for Payer: UHC Medicare Advantage |
$29.35
|
| Rate for Payer: UHCCP DNSP |
$29.35
|
| Rate for Payer: UHCCP Medicaid |
$15.73
|
| Rate for Payer: VA VA |
$29.35
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
IP
|
$169.12
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$109.93 |
| Max. Negotiated Rate |
$169.12 |
| Rate for Payer: Aetna Commercial |
$152.21
|
| Rate for Payer: ASR ASR |
$164.05
|
| Rate for Payer: ASR Commercial |
$164.05
|
| Rate for Payer: BCBS Trust/PPO |
$137.82
|
| Rate for Payer: BCN Commercial |
$131.12
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$158.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Healthscope Commercial |
$169.12
|
| Rate for Payer: Healthscope Whirlpool |
$164.05
|
| Rate for Payer: Mclaren Commercial |
$152.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$138.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.83
|
|
