|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,113.31 |
| Max. Negotiated Rate |
$3,251.25 |
| Rate for Payer: Aetna Commercial |
$2,926.12
|
| Rate for Payer: ASR ASR |
$3,153.71
|
| Rate for Payer: ASR Commercial |
$3,153.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,649.44
|
| Rate for Payer: BCN Commercial |
$2,520.69
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$3,056.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Healthscope Commercial |
$3,251.25
|
| Rate for Payer: Healthscope Whirlpool |
$3,153.71
|
| Rate for Payer: Mclaren Commercial |
$2,926.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: Nomi Health Commercial |
$2,666.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,861.10
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$3,251.25 |
| Rate for Payer: Aetna Commercial |
$2,926.12
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$3,153.71
|
| Rate for Payer: ASR Commercial |
$3,153.71
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,662.45
|
| Rate for Payer: BCN Commercial |
$2,520.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$3,056.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,251.25
|
| Rate for Payer: Healthscope Whirlpool |
$3,153.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$2,926.12
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: Nomi Health Commercial |
$2,666.02
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,848.75
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,279.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,861.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,012.55 |
| Max. Negotiated Rate |
$3,096.23 |
| Rate for Payer: Aetna Commercial |
$2,786.61
|
| Rate for Payer: ASR ASR |
$3,003.34
|
| Rate for Payer: ASR Commercial |
$3,003.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,523.12
|
| Rate for Payer: BCN Commercial |
$2,400.51
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,910.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$3,096.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,003.34
|
| Rate for Payer: Mclaren Commercial |
$2,786.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,724.68
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,234.61 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$2,786.61
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$3,003.34
|
| Rate for Payer: ASR Commercial |
$3,003.34
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,535.50
|
| Rate for Payer: BCN Commercial |
$2,400.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,910.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,096.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,003.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$2,786.61
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.26
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,724.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.38 |
| Max. Negotiated Rate |
$3,096.23 |
| Rate for Payer: Aetna Commercial |
$2,786.61
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$3,003.34
|
| Rate for Payer: ASR Commercial |
$3,003.34
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,535.50
|
| Rate for Payer: BCN Commercial |
$2,400.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,910.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,096.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,003.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$2,786.61
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.47
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$452.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,724.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,012.55 |
| Max. Negotiated Rate |
$3,096.23 |
| Rate for Payer: Aetna Commercial |
$2,786.61
|
| Rate for Payer: ASR ASR |
$3,003.34
|
| Rate for Payer: ASR Commercial |
$3,003.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,523.12
|
| Rate for Payer: BCN Commercial |
$2,400.51
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,910.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$3,096.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,003.34
|
| Rate for Payer: Mclaren Commercial |
$2,786.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,724.68
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$17.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.40
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$9.64
|
| Rate for Payer: BCBS MAPPO |
$17.12
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$17.12
|
| 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 |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$9.18
|
| Rate for Payer: Mclaren Medicare |
$17.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.98
|
| Rate for Payer: Meridian Medicaid |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$16.26
|
| Rate for Payer: PACE SWMI |
$17.12
|
| Rate for Payer: PHP Commercial |
$18.83
|
| Rate for Payer: PHP Medicaid |
$9.18
|
| Rate for Payer: PHP Medicare Advantage |
$17.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.18
|
| 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 |
$17.12
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$17.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.12
|
| Rate for Payer: UHC Exchange |
$26.54
|
| Rate for Payer: UHC Medicare Advantage |
$17.12
|
| Rate for Payer: UHCCP DNSP |
$17.12
|
| Rate for Payer: UHCCP Medicaid |
$9.18
|
| Rate for Payer: VA VA |
$17.12
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| 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 BILE BODY FLUID
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$31.50
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Complete |
$1.22
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.17
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$1.16
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$1.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$2.39
|
| Rate for Payer: PHP Medicaid |
$1.16
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.87
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$27.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.36
|
| Rate for Payer: UHC Medicare Advantage |
$2.17
|
| Rate for Payer: UHCCP DNSP |
$2.17
|
| Rate for Payer: UHCCP Medicaid |
$1.16
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,644.23 |
| Max. Negotiated Rate |
$9,476.05 |
| Rate for Payer: Aetna Commercial |
$3,661.24
|
| Rate for Payer: Aetna Medicare |
$6,113.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,641.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,641.98
|
| Rate for Payer: ASR ASR |
$3,946.00
|
| Rate for Payer: ASR Commercial |
$3,946.00
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,331.32
|
| Rate for Payer: BCN Commercial |
$3,153.95
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$3,823.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$4,068.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,946.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,113.58
|
| Rate for Payer: Mclaren Commercial |
$3,661.24
|
| Rate for Payer: Mclaren Medicaid |
$3,276.88
|
| Rate for Payer: Mclaren Medicare |
$6,113.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,419.26
|
| Rate for Payer: Meridian Medicaid |
$3,440.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,030.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: Nomi Health Commercial |
$3,335.79
|
| Rate for Payer: PACE Medicare |
$5,807.90
|
| Rate for Payer: PACE SWMI |
$6,113.58
|
| Rate for Payer: PHP Commercial |
$6,724.94
|
| Rate for Payer: PHP Medicaid |
$3,276.88
|
| Rate for Payer: PHP Medicare Advantage |
$6,113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,276.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,564.42
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,851.70
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,579.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,113.58
|
| Rate for Payer: UHC Exchange |
$9,476.05
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.58
|
| Rate for Payer: UHCCP DNSP |
$6,113.58
|
| Rate for Payer: UHCCP Medicaid |
$3,276.88
|
| Rate for Payer: VA VA |
$6,113.58
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,644.23 |
| Max. Negotiated Rate |
$4,068.04 |
| Rate for Payer: Aetna Commercial |
$3,661.24
|
| Rate for Payer: ASR ASR |
$3,946.00
|
| Rate for Payer: ASR Commercial |
$3,946.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,315.05
|
| Rate for Payer: BCN Commercial |
$3,153.95
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$3,823.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Healthscope Commercial |
$4,068.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,946.00
|
| Rate for Payer: Mclaren Commercial |
$3,661.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: Nomi Health Commercial |
$3,335.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,579.88
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$304.91 |
| Max. Negotiated Rate |
$469.09 |
| Rate for Payer: Aetna Commercial |
$422.18
|
| Rate for Payer: ASR ASR |
$455.02
|
| Rate for Payer: ASR Commercial |
$455.02
|
| Rate for Payer: BCBS Trust/PPO |
$382.26
|
| Rate for Payer: BCN Commercial |
$363.69
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$440.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$469.09
|
| Rate for Payer: Healthscope Whirlpool |
$455.02
|
| Rate for Payer: Mclaren Commercial |
$422.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: Nomi Health Commercial |
$384.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.80
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$187.64 |
| Max. Negotiated Rate |
$469.09 |
| Rate for Payer: Aetna Commercial |
$422.18
|
| Rate for Payer: Aetna Medicare |
$234.54
|
| Rate for Payer: ASR ASR |
$455.02
|
| Rate for Payer: ASR Commercial |
$455.02
|
| Rate for Payer: BCBS Complete |
$187.64
|
| Rate for Payer: BCBS Trust/PPO |
$384.14
|
| Rate for Payer: BCN Commercial |
$363.69
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$440.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$469.09
|
| Rate for Payer: Healthscope Whirlpool |
$455.02
|
| Rate for Payer: Mclaren Commercial |
$422.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: Nomi Health Commercial |
$384.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.02
|
| Rate for Payer: Priority Health Narrow Network |
$328.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.80
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,206.15 |
| Max. Negotiated Rate |
$1,855.62 |
| Rate for Payer: Aetna Commercial |
$1,670.06
|
| Rate for Payer: ASR ASR |
$1,799.95
|
| Rate for Payer: ASR Commercial |
$1,799.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,512.14
|
| Rate for Payer: BCN Commercial |
$1,438.66
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,744.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,855.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,799.95
|
| Rate for Payer: Mclaren Commercial |
$1,670.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: Nomi Health Commercial |
$1,521.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,632.95
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$742.25 |
| Max. Negotiated Rate |
$1,855.62 |
| Rate for Payer: Aetna Commercial |
$1,670.06
|
| Rate for Payer: Aetna Medicare |
$927.81
|
| Rate for Payer: ASR ASR |
$1,799.95
|
| Rate for Payer: ASR Commercial |
$1,799.95
|
| Rate for Payer: BCBS Complete |
$742.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,519.57
|
| Rate for Payer: BCN Commercial |
$1,438.66
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,744.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,855.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,799.95
|
| Rate for Payer: Mclaren Commercial |
$1,670.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: Nomi Health Commercial |
$1,521.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,625.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,632.95
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
IP
|
$28,810.00
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,726.50 |
| Max. Negotiated Rate |
$28,810.00 |
| Rate for Payer: Aetna Commercial |
$25,929.00
|
| Rate for Payer: ASR ASR |
$27,945.70
|
| Rate for Payer: ASR Commercial |
$27,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$23,477.27
|
| Rate for Payer: BCN Commercial |
$22,336.39
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cofinity Commercial |
$27,081.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,048.00
|
| Rate for Payer: Healthscope Commercial |
$28,810.00
|
| Rate for Payer: Healthscope Whirlpool |
$27,945.70
|
| Rate for Payer: Mclaren Commercial |
$25,929.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,488.50
|
| Rate for Payer: Nomi Health Commercial |
$23,624.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,726.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,352.80
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
OP
|
$28,810.00
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,467.58 |
| Max. Negotiated Rate |
$28,810.00 |
| Rate for Payer: Aetna Commercial |
$25,929.00
|
| Rate for Payer: Aetna Medicare |
$10,200.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: ASR ASR |
$27,945.70
|
| Rate for Payer: ASR Commercial |
$27,945.70
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$23,592.51
|
| Rate for Payer: BCN Commercial |
$22,336.39
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cofinity Commercial |
$27,081.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,048.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Healthscope Commercial |
$28,810.00
|
| Rate for Payer: Healthscope Whirlpool |
$27,945.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,200.71
|
| Rate for Payer: Mclaren Commercial |
$25,929.00
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,488.50
|
| Rate for Payer: Nomi Health Commercial |
$23,624.20
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Commercial |
$11,220.78
|
| Rate for Payer: PHP Medicaid |
$5,467.58
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,726.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,243.32
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$20,195.81
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,352.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$15,811.10
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP DNSP |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
OP
|
$21,200.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,276.88 |
| Max. Negotiated Rate |
$21,200.00 |
| Rate for Payer: Aetna Commercial |
$19,080.00
|
| Rate for Payer: Aetna Medicare |
$6,113.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,641.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,641.98
|
| Rate for Payer: ASR ASR |
$20,564.00
|
| Rate for Payer: ASR Commercial |
$20,564.00
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$17,360.68
|
| Rate for Payer: BCN Commercial |
$16,436.36
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cofinity Commercial |
$19,928.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,960.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$21,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,564.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,113.58
|
| Rate for Payer: Mclaren Commercial |
$19,080.00
|
| Rate for Payer: Mclaren Medicaid |
$3,276.88
|
| Rate for Payer: Mclaren Medicare |
$6,113.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,419.26
|
| Rate for Payer: Meridian Medicaid |
$3,440.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,030.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,020.00
|
| Rate for Payer: Nomi Health Commercial |
$17,384.00
|
| Rate for Payer: PACE Medicare |
$5,807.90
|
| Rate for Payer: PACE SWMI |
$6,113.58
|
| Rate for Payer: PHP Commercial |
$6,724.94
|
| Rate for Payer: PHP Medicaid |
$3,276.88
|
| Rate for Payer: PHP Medicare Advantage |
$6,113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,276.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,780.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,575.44
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$14,861.20
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,656.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,113.58
|
| Rate for Payer: UHC Exchange |
$9,476.05
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.58
|
| Rate for Payer: UHCCP DNSP |
$6,113.58
|
| Rate for Payer: UHCCP Medicaid |
$3,276.88
|
| Rate for Payer: VA VA |
$6,113.58
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
IP
|
$21,200.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,780.00 |
| Max. Negotiated Rate |
$21,200.00 |
| Rate for Payer: Aetna Commercial |
$19,080.00
|
| Rate for Payer: ASR ASR |
$20,564.00
|
| Rate for Payer: ASR Commercial |
$20,564.00
|
| Rate for Payer: BCBS Trust/PPO |
$17,275.88
|
| Rate for Payer: BCN Commercial |
$16,436.36
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cofinity Commercial |
$19,928.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,960.00
|
| Rate for Payer: Healthscope Commercial |
$21,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,564.00
|
| Rate for Payer: Mclaren Commercial |
$19,080.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,020.00
|
| Rate for Payer: Nomi Health Commercial |
$17,384.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,780.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,656.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
IP
|
$9,700.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,305.00 |
| Max. Negotiated Rate |
$9,700.00 |
| Rate for Payer: Aetna Commercial |
$8,730.00
|
| Rate for Payer: ASR ASR |
$9,409.00
|
| Rate for Payer: ASR Commercial |
$9,409.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,904.53
|
| Rate for Payer: BCN Commercial |
$7,520.41
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cofinity Commercial |
$9,118.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,760.00
|
| Rate for Payer: Healthscope Commercial |
$9,700.00
|
| Rate for Payer: Healthscope Whirlpool |
$9,409.00
|
| Rate for Payer: Mclaren Commercial |
$8,730.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,245.00
|
| Rate for Payer: Nomi Health Commercial |
$7,954.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,305.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,536.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
OP
|
$9,700.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,853.33 |
| Max. Negotiated Rate |
$9,700.00 |
| Rate for Payer: Aetna Commercial |
$8,730.00
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$9,409.00
|
| Rate for Payer: ASR Commercial |
$9,409.00
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$7,943.33
|
| Rate for Payer: BCN Commercial |
$7,520.41
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cofinity Commercial |
$9,118.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$9,700.00
|
| Rate for Payer: Healthscope Whirlpool |
$9,409.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$8,730.00
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,245.00
|
| Rate for Payer: Nomi Health Commercial |
$7,954.00
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,305.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,499.14
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$6,799.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,536.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$5.52
|
| Rate for Payer: PHP Medicaid |
$2.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.38
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$12.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$7.78
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP DNSP |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: VA VA |
$5.02
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$28.56 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$5.52
|
| Rate for Payer: PHP Medicaid |
$2.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.56
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$22.85
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$7.78
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP DNSP |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: VA VA |
$5.02
|
|
