|
HC BENZO CONFIRMATION, U
|
Facility
|
IP
|
$30.64
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
30000163
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.92 |
| Max. Negotiated Rate |
$30.64 |
| Rate for Payer: Aetna Commercial |
$27.58
|
| Rate for Payer: ASR ASR |
$29.72
|
| Rate for Payer: ASR Commercial |
$29.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.97
|
| Rate for Payer: BCN Commercial |
$23.76
|
| Rate for Payer: Cash Price |
$24.51
|
| Rate for Payer: Cofinity Commercial |
$28.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.51
|
| Rate for Payer: Healthscope Commercial |
$30.64
|
| Rate for Payer: Healthscope Whirlpool |
$29.72
|
| Rate for Payer: Mclaren Commercial |
$27.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.96
|
|
|
HC BENZO CONFIRMATION, U
|
Facility
|
OP
|
$30.64
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
30000163
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$30.64 |
| Rate for Payer: Aetna Commercial |
$27.58
|
| Rate for Payer: Aetna Medicare |
$15.32
|
| Rate for Payer: ASR ASR |
$29.72
|
| Rate for Payer: ASR Commercial |
$29.72
|
| Rate for Payer: BCBS Complete |
$12.26
|
| Rate for Payer: BCBS Trust/PPO |
$25.09
|
| Rate for Payer: BCN Commercial |
$23.76
|
| Rate for Payer: Cash Price |
$24.51
|
| Rate for Payer: Cofinity Commercial |
$28.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.51
|
| Rate for Payer: Healthscope Commercial |
$30.64
|
| Rate for Payer: Healthscope Whirlpool |
$29.72
|
| Rate for Payer: Mclaren Commercial |
$27.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.85
|
| Rate for Payer: Priority Health Narrow Network |
$21.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.96
|
|
|
HC BENZODIAZAPINE URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.08 |
| Max. Negotiated Rate |
$101.66 |
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: ASR ASR |
$98.61
|
| Rate for Payer: ASR Commercial |
$98.61
|
| Rate for Payer: BCBS Trust/PPO |
$82.84
|
| Rate for Payer: BCN Commercial |
$78.82
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$95.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$101.66
|
| Rate for Payer: Healthscope Whirlpool |
$98.61
|
| Rate for Payer: Mclaren Commercial |
$91.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.46
|
|
|
HC BENZODIAZAPINE URIN
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000123
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$101.66 |
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$98.61
|
| Rate for Payer: ASR Commercial |
$98.61
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$83.25
|
| Rate for Payer: BCN Commercial |
$78.82
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$95.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$101.66
|
| Rate for Payer: Healthscope Whirlpool |
$98.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$91.49
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.07
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$71.26
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC BENZODIAZEPINE URINE CONFIRM
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30100594
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC BENZODIAZEPINE URINE CONFIRM
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30100594
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: Aetna Medicare |
$31.62
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS Trust/PPO |
$51.79
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC BERMUDA GRASS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200119
|
|
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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 BERMUDA GRASS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200119
|
|
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 BETA 2 GLYCOPROTEIN I CMPT
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200139
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I CMPT
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200139
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BETA 2 GLYCOPROTEIN I IGA M A
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200444
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BETA 2 GLYCOPROTEIN I IGA M A
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200444
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200459
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200459
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG M A
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200140
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGG M A
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200140
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BETA 2 GLYCOPROTEIN I IGM M A
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200443
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GLYCOPROTEIN I IGM M A
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200443
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BETA 2 GP1 AB IGA
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$29.67
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
|
HC BETA 2 GP1 AB IGA
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$39.45 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.90
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$25.52
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GP1 AB IGG
|
Facility
|
IP
|
$43.20
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.08 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$38.88
|
| Rate for Payer: ASR ASR |
$41.90
|
| Rate for Payer: ASR Commercial |
$41.90
|
| Rate for Payer: BCBS Trust/PPO |
$35.20
|
| Rate for Payer: BCN Commercial |
$33.49
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$40.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Healthscope Whirlpool |
$41.90
|
| Rate for Payer: Mclaren Commercial |
$38.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.72
|
| Rate for Payer: Nomi Health Commercial |
$35.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.02
|
|
|
HC BETA 2 GP1 AB IGG
|
Facility
|
OP
|
$43.20
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$38.88
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$41.90
|
| Rate for Payer: ASR Commercial |
$41.90
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$35.38
|
| Rate for Payer: BCN Commercial |
$33.49
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$40.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Healthscope Whirlpool |
$41.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$38.88
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.72
|
| Rate for Payer: Nomi Health Commercial |
$35.42
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.85
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$30.28
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
OP
|
$51.40
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$51.40 |
| Rate for Payer: Aetna Commercial |
$46.26
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$49.86
|
| Rate for Payer: ASR Commercial |
$49.86
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.09
|
| Rate for Payer: BCN Commercial |
$39.85
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.12
|
| Rate for Payer: Cash Price |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$48.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$51.40
|
| Rate for Payer: Healthscope Whirlpool |
$49.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.26
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.69
|
| Rate for Payer: Nomi Health Commercial |
$42.15
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.04
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$36.03
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.64
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
IP
|
$51.40
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.41 |
| Max. Negotiated Rate |
$51.40 |
| Rate for Payer: Aetna Commercial |
$46.26
|
| Rate for Payer: ASR ASR |
$49.86
|
| Rate for Payer: ASR Commercial |
$49.86
|
| Rate for Payer: BCBS Trust/PPO |
$41.89
|
| Rate for Payer: BCN Commercial |
$39.85
|
| Rate for Payer: Cash Price |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$48.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.12
|
| Rate for Payer: Healthscope Commercial |
$51.40
|
| Rate for Payer: Healthscope Whirlpool |
$49.86
|
| Rate for Payer: Mclaren Commercial |
$46.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.69
|
| Rate for Payer: Nomi Health Commercial |
$42.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.23
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
IP
|
$42.66
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.73 |
| Max. Negotiated Rate |
$42.66 |
| Rate for Payer: Aetna Commercial |
$38.39
|
| Rate for Payer: ASR ASR |
$41.38
|
| Rate for Payer: ASR Commercial |
$41.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.76
|
| Rate for Payer: BCN Commercial |
$33.07
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$40.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$42.66
|
| Rate for Payer: Healthscope Whirlpool |
$41.38
|
| Rate for Payer: Mclaren Commercial |
$38.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.54
|
|
