|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
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 TOTAL TRANSCUTANEOUS
|
Facility
|
IP
|
$47.48
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.86 |
| Max. Negotiated Rate |
$47.48 |
| Rate for Payer: Aetna Commercial |
$42.73
|
| Rate for Payer: ASR ASR |
$46.06
|
| Rate for Payer: ASR Commercial |
$46.06
|
| Rate for Payer: BCBS Trust/PPO |
$38.69
|
| Rate for Payer: BCN Commercial |
$36.81
|
| Rate for Payer: Cash Price |
$37.98
|
| Rate for Payer: Cofinity Commercial |
$44.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.98
|
| Rate for Payer: Healthscope Commercial |
$47.48
|
| Rate for Payer: Healthscope Whirlpool |
$46.06
|
| Rate for Payer: Mclaren Commercial |
$42.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.36
|
| Rate for Payer: Nomi Health Commercial |
$38.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.78
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
OP
|
$47.48
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$47.48 |
| Rate for Payer: Aetna Commercial |
$42.73
|
| 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 |
$46.06
|
| Rate for Payer: ASR Commercial |
$46.06
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$38.88
|
| Rate for Payer: BCN Commercial |
$36.81
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$37.98
|
| Rate for Payer: Cash Price |
$37.98
|
| Rate for Payer: Cofinity Commercial |
$44.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$47.48
|
| Rate for Payer: Healthscope Whirlpool |
$46.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$42.73
|
| 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 |
$40.36
|
| Rate for Payer: Nomi Health Commercial |
$38.93
|
| 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 |
$30.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.66
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$14.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.78
|
| 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 BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
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 BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
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 |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| 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 BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$32.09
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.31
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
OP
|
$101.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$101.95 |
| Rate for Payer: Aetna Commercial |
$91.76
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$98.89
|
| Rate for Payer: ASR Commercial |
$98.89
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$83.49
|
| Rate for Payer: BCN Commercial |
$79.04
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$95.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$101.95
|
| Rate for Payer: Healthscope Whirlpool |
$98.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$91.76
|
| 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 |
$86.66
|
| Rate for Payer: Nomi Health Commercial |
$83.60
|
| 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 |
$66.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.33
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$71.47
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.72
|
| 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 BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
IP
|
$101.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.27 |
| Max. Negotiated Rate |
$101.95 |
| Rate for Payer: Aetna Commercial |
$91.76
|
| Rate for Payer: ASR ASR |
$98.89
|
| Rate for Payer: ASR Commercial |
$98.89
|
| Rate for Payer: BCBS Trust/PPO |
$83.08
|
| Rate for Payer: BCN Commercial |
$79.04
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$95.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.56
|
| Rate for Payer: Healthscope Commercial |
$101.95
|
| Rate for Payer: Healthscope Whirlpool |
$98.89
|
| Rate for Payer: Mclaren Commercial |
$91.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.66
|
| Rate for Payer: Nomi Health Commercial |
$83.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.72
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$32.09
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.31
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
IP
|
$163.20
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: Aetna Commercial |
$146.88
|
| Rate for Payer: ASR ASR |
$158.30
|
| Rate for Payer: ASR Commercial |
$158.30
|
| Rate for Payer: BCBS Trust/PPO |
$132.99
|
| Rate for Payer: BCN Commercial |
$126.53
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Healthscope Commercial |
$163.20
|
| Rate for Payer: Healthscope Whirlpool |
$158.30
|
| Rate for Payer: Mclaren Commercial |
$146.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.72
|
| Rate for Payer: Nomi Health Commercial |
$133.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.62
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
OP
|
$163.20
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$65.28 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: Aetna Commercial |
$146.88
|
| Rate for Payer: Aetna Medicare |
$81.60
|
| Rate for Payer: ASR ASR |
$158.30
|
| Rate for Payer: ASR Commercial |
$158.30
|
| Rate for Payer: BCBS Complete |
$65.28
|
| Rate for Payer: BCBS Trust/PPO |
$133.64
|
| Rate for Payer: BCN Commercial |
$126.53
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Healthscope Commercial |
$163.20
|
| Rate for Payer: Healthscope Whirlpool |
$158.30
|
| Rate for Payer: Mclaren Commercial |
$146.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.72
|
| Rate for Payer: Nomi Health Commercial |
$133.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.00
|
| Rate for Payer: Priority Health Narrow Network |
$114.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.62
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.96 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$37.18 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$26.41
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.44
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.26
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$22.61
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
OP
|
$1,686.53
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,517.88
|
| 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 |
$1,635.93
|
| Rate for Payer: ASR Commercial |
$1,635.93
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.10
|
| Rate for Payer: BCN Commercial |
$1,307.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,349.22
|
| Rate for Payer: Cash Price |
$1,349.22
|
| Rate for Payer: Cofinity Commercial |
$1,585.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,686.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,517.88
|
| 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 |
$1,433.55
|
| Rate for Payer: Nomi Health Commercial |
$1,382.95
|
| 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 |
$1,096.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,472.44
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,177.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.15
|
| 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 BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
IP
|
$1,686.53
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,096.24 |
| Max. Negotiated Rate |
$1,686.53 |
| Rate for Payer: Aetna Commercial |
$1,517.88
|
| Rate for Payer: ASR ASR |
$1,635.93
|
| Rate for Payer: ASR Commercial |
$1,635.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,374.35
|
| Rate for Payer: BCN Commercial |
$1,307.57
|
| Rate for Payer: Cash Price |
$1,349.22
|
| Rate for Payer: Cofinity Commercial |
$1,585.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.22
|
| Rate for Payer: Healthscope Commercial |
$1,686.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.93
|
| Rate for Payer: Mclaren Commercial |
$1,517.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.55
|
| Rate for Payer: Nomi Health Commercial |
$1,382.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.15
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
IP
|
$8.16
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$8.16 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: ASR ASR |
$7.92
|
| Rate for Payer: ASR Commercial |
$7.92
|
| Rate for Payer: BCBS Trust/PPO |
$6.65
|
| Rate for Payer: BCN Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$8.16
|
| Rate for Payer: Healthscope Whirlpool |
$7.92
|
| Rate for Payer: Mclaren Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.18
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
OP
|
$8.16
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$3.26 |
| Max. Negotiated Rate |
$8.16 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: ASR ASR |
$7.92
|
| Rate for Payer: ASR Commercial |
$7.92
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS Trust/PPO |
$6.68
|
| Rate for Payer: BCN Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$8.16
|
| Rate for Payer: Healthscope Whirlpool |
$7.92
|
| Rate for Payer: Mclaren Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.15
|
| Rate for Payer: Priority Health Narrow Network |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.18
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
IP
|
$2,105.54
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,368.60 |
| Max. Negotiated Rate |
$2,105.54 |
| Rate for Payer: Aetna Commercial |
$1,894.99
|
| Rate for Payer: ASR ASR |
$2,042.37
|
| Rate for Payer: ASR Commercial |
$2,042.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,715.80
|
| Rate for Payer: BCN Commercial |
$1,632.43
|
| Rate for Payer: Cash Price |
$1,684.43
|
| Rate for Payer: Cofinity Commercial |
$1,979.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.43
|
| Rate for Payer: Healthscope Commercial |
$2,105.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,042.37
|
| Rate for Payer: Mclaren Commercial |
$1,894.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,789.71
|
| Rate for Payer: Nomi Health Commercial |
$1,726.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,852.88
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
OP
|
$2,105.54
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,734.04 |
| Rate for Payer: Aetna Commercial |
$1,894.99
|
| 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 |
$2,042.37
|
| Rate for Payer: ASR Commercial |
$2,042.37
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.23
|
| Rate for Payer: BCN Commercial |
$1,632.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,684.43
|
| Rate for Payer: Cash Price |
$1,684.43
|
| Rate for Payer: Cofinity Commercial |
$1,979.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,105.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,042.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,894.99
|
| 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 |
$1,789.71
|
| Rate for Payer: Nomi Health Commercial |
$1,726.54
|
| 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 |
$1,368.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,734.04
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,187.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,852.88
|
| 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 BIOPSY, BONE, OPEN, DEEP
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| 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 |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,963.49
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| 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 |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| 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 |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,170.85
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,536.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
| 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 BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.27 |
| Max. Negotiated Rate |
$3,618.87 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,949.02
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,136.81
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$2,823.13
|
| 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 |
$3,042.71
|
| Rate for Payer: ASR Commercial |
$3,042.71
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,568.73
|
| Rate for Payer: BCN Commercial |
$2,431.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,509.45
|
| Rate for Payer: Cash Price |
$2,509.45
|
| Rate for Payer: Cofinity Commercial |
$2,948.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,509.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,136.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,042.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$2,823.13
|
| 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 |
$2,666.29
|
| Rate for Payer: Nomi Health Commercial |
$2,572.18
|
| 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 |
$2,038.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,748.47
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,198.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,760.39
|
| 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 BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,136.81
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,038.93 |
| Max. Negotiated Rate |
$3,136.81 |
| Rate for Payer: Aetna Commercial |
$2,823.13
|
| Rate for Payer: ASR ASR |
$3,042.71
|
| Rate for Payer: ASR Commercial |
$3,042.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,556.19
|
| Rate for Payer: BCN Commercial |
$2,431.97
|
| Rate for Payer: Cash Price |
$2,509.45
|
| Rate for Payer: Cofinity Commercial |
$2,948.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,509.45
|
| Rate for Payer: Healthscope Commercial |
$3,136.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,042.71
|
| Rate for Payer: Mclaren Commercial |
$2,823.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,666.29
|
| Rate for Payer: Nomi Health Commercial |
$2,572.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,038.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,760.39
|
|
