|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
OP
|
$7,849.99
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,904.50 |
| Max. Negotiated Rate |
$7,849.99 |
| Rate for Payer: Aetna Commercial |
$7,064.99
|
| Rate for Payer: Aetna Medicare |
$2,904.50
|
| Rate for Payer: ASR ASR |
$7,614.49
|
| Rate for Payer: BCBS Complete |
$3,140.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,472.32
|
| Rate for Payer: BCN Commercial |
$6,472.32
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cofinity Commercial |
$7,378.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,279.99
|
| Rate for Payer: Healthscope Commercial |
$7,614.49
|
| Rate for Payer: Healthscope Whirlpool |
$7,849.99
|
| Rate for Payer: Mclaren Commercial |
$7,064.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,672.49
|
| Rate for Payer: Nomi Health Commercial |
$6,436.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,887.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,878.16
|
| Rate for Payer: Priority Health Narrow Network |
$5,502.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,907.99
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
OP
|
$9,904.61
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,664.71 |
| Max. Negotiated Rate |
$9,904.61 |
| Rate for Payer: Aetna Commercial |
$8,914.15
|
| Rate for Payer: Aetna Medicare |
$3,664.71
|
| Rate for Payer: ASR ASR |
$9,607.47
|
| Rate for Payer: BCBS Complete |
$3,961.84
|
| Rate for Payer: BCBS Trust/PPO |
$8,166.35
|
| Rate for Payer: BCN Commercial |
$8,166.35
|
| Rate for Payer: Cash Price |
$7,923.69
|
| Rate for Payer: Cofinity Commercial |
$9,310.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,923.69
|
| Rate for Payer: Healthscope Commercial |
$9,607.47
|
| Rate for Payer: Healthscope Whirlpool |
$9,904.61
|
| Rate for Payer: Mclaren Commercial |
$8,914.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,923.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,418.92
|
| Rate for Payer: Nomi Health Commercial |
$8,121.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,428.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,678.42
|
| Rate for Payer: Priority Health Narrow Network |
$6,943.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,716.06
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
IP
|
$9,904.61
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,428.46 |
| Max. Negotiated Rate |
$9,904.61 |
| Rate for Payer: Aetna Commercial |
$8,914.15
|
| Rate for Payer: ASR ASR |
$9,607.47
|
| Rate for Payer: BCBS Trust/PPO |
$8,133.67
|
| Rate for Payer: BCN Commercial |
$8,133.67
|
| Rate for Payer: Cash Price |
$7,923.69
|
| Rate for Payer: Cofinity Commercial |
$9,310.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,923.69
|
| Rate for Payer: Healthscope Commercial |
$9,607.47
|
| Rate for Payer: Healthscope Whirlpool |
$9,904.61
|
| Rate for Payer: Mclaren Commercial |
$8,914.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,418.92
|
| Rate for Payer: Nomi Health Commercial |
$8,121.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,428.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,716.06
|
|
|
HC CATH LAB STANDBY
|
Facility
|
IP
|
$509.70
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$382.27 |
| Max. Negotiated Rate |
$509.70 |
| Rate for Payer: Aetna Commercial |
$458.73
|
| Rate for Payer: ASR ASR |
$494.41
|
| Rate for Payer: BCBS Trust/PPO |
$418.57
|
| Rate for Payer: BCN Commercial |
$418.57
|
| Rate for Payer: Cash Price |
$407.76
|
| Rate for Payer: Cofinity Commercial |
$479.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.76
|
| Rate for Payer: Healthscope Commercial |
$494.41
|
| Rate for Payer: Healthscope Whirlpool |
$509.70
|
| Rate for Payer: Mclaren Commercial |
$458.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.25
|
| Rate for Payer: Nomi Health Commercial |
$417.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.54
|
|
|
HC CATH LAB STANDBY
|
Facility
|
OP
|
$509.70
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$188.59 |
| Max. Negotiated Rate |
$509.70 |
| Rate for Payer: Aetna Commercial |
$458.73
|
| Rate for Payer: Aetna Medicare |
$188.59
|
| Rate for Payer: ASR ASR |
$494.41
|
| Rate for Payer: BCBS Complete |
$203.88
|
| Rate for Payer: BCBS Trust/PPO |
$420.25
|
| Rate for Payer: BCN Commercial |
$420.25
|
| Rate for Payer: Cash Price |
$407.76
|
| Rate for Payer: Cofinity Commercial |
$479.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.76
|
| Rate for Payer: Healthscope Commercial |
$494.41
|
| Rate for Payer: Healthscope Whirlpool |
$509.70
|
| Rate for Payer: Mclaren Commercial |
$458.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.25
|
| Rate for Payer: Nomi Health Commercial |
$417.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$446.60
|
| Rate for Payer: Priority Health Narrow Network |
$357.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.54
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
OP
|
$156.06
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.74 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna Medicare |
$57.74
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: BCBS Complete |
$62.42
|
| Rate for Payer: BCBS Trust/PPO |
$128.67
|
| Rate for Payer: BCN Commercial |
$128.67
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$151.38
|
| Rate for Payer: Healthscope Whirlpool |
$156.06
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$136.74
|
| Rate for Payer: Priority Health Narrow Network |
$109.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
IP
|
$156.06
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$117.05 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: BCBS Trust/PPO |
$128.16
|
| Rate for Payer: BCN Commercial |
$128.16
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$151.38
|
| Rate for Payer: Healthscope Whirlpool |
$156.06
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
IP
|
$734.40
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.80 |
| Max. Negotiated Rate |
$734.40 |
| Rate for Payer: Aetna Commercial |
$660.96
|
| Rate for Payer: ASR ASR |
$712.37
|
| Rate for Payer: BCBS Trust/PPO |
$603.09
|
| Rate for Payer: BCN Commercial |
$603.09
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$690.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Healthscope Commercial |
$712.37
|
| Rate for Payer: Healthscope Whirlpool |
$734.40
|
| Rate for Payer: Mclaren Commercial |
$660.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.27
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
OP
|
$734.40
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.73 |
| Max. Negotiated Rate |
$734.40 |
| Rate for Payer: Aetna Commercial |
$660.96
|
| Rate for Payer: Aetna Medicare |
$271.73
|
| Rate for Payer: ASR ASR |
$712.37
|
| Rate for Payer: BCBS Complete |
$293.76
|
| Rate for Payer: BCBS Trust/PPO |
$605.51
|
| Rate for Payer: BCN Commercial |
$605.51
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$690.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Healthscope Commercial |
$712.37
|
| Rate for Payer: Healthscope Whirlpool |
$734.40
|
| Rate for Payer: Mclaren Commercial |
$660.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$587.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$643.48
|
| Rate for Payer: Priority Health Narrow Network |
$514.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.27
|
|
|
HC CAT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC CAT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
IP
|
$31.06
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.30 |
| Max. Negotiated Rate |
$31.06 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: ASR ASR |
$30.13
|
| Rate for Payer: BCBS Trust/PPO |
$25.51
|
| Rate for Payer: BCN Commercial |
$25.51
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cofinity Commercial |
$29.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.85
|
| Rate for Payer: Healthscope Commercial |
$30.13
|
| Rate for Payer: Healthscope Whirlpool |
$31.06
|
| Rate for Payer: Mclaren Commercial |
$27.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.40
|
| Rate for Payer: Nomi Health Commercial |
$25.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.33
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
OP
|
$31.06
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: Aetna Medicare |
$7.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.71
|
| Rate for Payer: ASR ASR |
$30.13
|
| Rate for Payer: BCBS Complete |
$4.27
|
| Rate for Payer: BCBS MAPPO |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.61
|
| Rate for Payer: BCN Commercial |
$25.61
|
| Rate for Payer: BCN Medicare Advantage |
$7.77
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cofinity Commercial |
$29.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.77
|
| Rate for Payer: Healthscope Commercial |
$30.13
|
| Rate for Payer: Healthscope Whirlpool |
$31.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.77
|
| Rate for Payer: Mclaren Commercial |
$27.95
|
| Rate for Payer: Mclaren Medicaid |
$7.77
|
| Rate for Payer: Mclaren Medicare |
$7.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.16
|
| Rate for Payer: Meridian Medicaid |
$4.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.40
|
| Rate for Payer: Nomi Health Commercial |
$25.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.30
|
| Rate for Payer: PACE Medicare |
$7.38
|
| Rate for Payer: PACE SWMI |
$7.77
|
| Rate for Payer: PHP Commercial |
$8.55
|
| Rate for Payer: PHP Medicaid |
$4.16
|
| Rate for Payer: PHP Medicare Advantage |
$7.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.08
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health Narrow Network |
$44.07
|
| Rate for Payer: Railroad Medicare Medicare |
$7.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.77
|
| Rate for Payer: UHC Exchange |
$12.04
|
| Rate for Payer: UHC Medicaid |
$4.06
|
| Rate for Payer: UHCCP DNSP |
$7.77
|
| Rate for Payer: UHCCP Medicaid |
$4.06
|
| Rate for Payer: VA VA |
$7.77
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$41.16 |
| Rate for Payer: Aetna Commercial |
$17.19
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$18.53
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$15.75
|
| Rate for Payer: BCN Commercial |
$15.75
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$17.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Healthscope Whirlpool |
$19.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$17.19
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$32.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.32 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$17.19
|
| Rate for Payer: ASR ASR |
$18.53
|
| Rate for Payer: BCBS Trust/PPO |
$15.68
|
| Rate for Payer: BCN Commercial |
$15.68
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$17.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Healthscope Whirlpool |
$19.10
|
| Rate for Payer: Mclaren Commercial |
$17.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.81
|
|
|
HC C DIFFICILE PCR
|
Facility
|
IP
|
$143.47
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$143.47 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: ASR ASR |
$139.17
|
| Rate for Payer: BCBS Trust/PPO |
$117.82
|
| Rate for Payer: BCN Commercial |
$117.82
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$134.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.78
|
| Rate for Payer: Healthscope Commercial |
$139.17
|
| Rate for Payer: Healthscope Whirlpool |
$143.47
|
| Rate for Payer: Mclaren Commercial |
$129.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.95
|
| Rate for Payer: Nomi Health Commercial |
$117.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.25
|
|
|
HC C DIFFICILE PCR
|
Facility
|
OP
|
$143.47
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$143.47 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$37.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.59
|
| Rate for Payer: ASR ASR |
$139.17
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$37.27
|
| Rate for Payer: BCBS Trust/PPO |
$118.29
|
| Rate for Payer: BCN Commercial |
$118.29
|
| Rate for Payer: BCN Medicare Advantage |
$37.27
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$134.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.27
|
| Rate for Payer: Healthscope Commercial |
$139.17
|
| Rate for Payer: Healthscope Whirlpool |
$143.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.27
|
| Rate for Payer: Mclaren Commercial |
$129.12
|
| Rate for Payer: Mclaren Medicaid |
$37.27
|
| Rate for Payer: Mclaren Medicare |
$37.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.13
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.95
|
| Rate for Payer: Nomi Health Commercial |
$117.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.60
|
| Rate for Payer: PACE Medicare |
$35.41
|
| Rate for Payer: PACE SWMI |
$37.27
|
| Rate for Payer: PHP Commercial |
$41.00
|
| Rate for Payer: PHP Medicaid |
$19.98
|
| Rate for Payer: PHP Medicare Advantage |
$37.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$125.71
|
| Rate for Payer: Priority Health Medicare |
$37.27
|
| Rate for Payer: Priority Health Narrow Network |
$100.57
|
| Rate for Payer: Railroad Medicare Medicare |
$37.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.27
|
| Rate for Payer: UHC Exchange |
$57.77
|
| Rate for Payer: UHC Medicaid |
$19.49
|
| Rate for Payer: UHCCP DNSP |
$37.27
|
| Rate for Payer: UHCCP Medicaid |
$19.49
|
| Rate for Payer: VA VA |
$37.27
|
|
|
HC C DIFF TOXIN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$150.72 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$150.72
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$120.57
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC C DIFF TOXIN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$133.38
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.03 |
| Max. Negotiated Rate |
$133.38 |
| Rate for Payer: Aetna Commercial |
$120.04
|
| Rate for Payer: ASR ASR |
$129.38
|
| Rate for Payer: BCBS Trust/PPO |
$109.53
|
| Rate for Payer: BCN Commercial |
$109.53
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Commercial |
$125.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Healthscope Commercial |
$129.38
|
| Rate for Payer: Healthscope Whirlpool |
$133.38
|
| Rate for Payer: Mclaren Commercial |
$120.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Nomi Health Commercial |
$109.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.37
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$133.38
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$143.46 |
| Rate for Payer: Aetna Commercial |
$120.04
|
| Rate for Payer: Aetna Medicare |
$18.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: ASR ASR |
$129.38
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$109.97
|
| Rate for Payer: BCN Commercial |
$109.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Commercial |
$125.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$129.38
|
| Rate for Payer: Healthscope Whirlpool |
$133.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.96
|
| Rate for Payer: Mclaren Commercial |
$120.04
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Nomi Health Commercial |
$109.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$20.86
|
| Rate for Payer: PHP Medicaid |
$10.16
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.96
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.96
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$188.06
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$141.04 |
| Max. Negotiated Rate |
$188.06 |
| Rate for Payer: Aetna Commercial |
$169.25
|
| Rate for Payer: ASR ASR |
$182.42
|
| Rate for Payer: BCBS Trust/PPO |
$154.43
|
| Rate for Payer: BCN Commercial |
$154.43
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cofinity Commercial |
$176.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.45
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Healthscope Whirlpool |
$188.06
|
| Rate for Payer: Mclaren Commercial |
$169.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.85
|
| Rate for Payer: Nomi Health Commercial |
$154.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.49
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$188.06
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$188.06 |
| Rate for Payer: Aetna Commercial |
$169.25
|
| Rate for Payer: Aetna Medicare |
$18.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: ASR ASR |
$182.42
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$155.06
|
| Rate for Payer: BCN Commercial |
$155.06
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cofinity Commercial |
$176.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Healthscope Whirlpool |
$188.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.96
|
| Rate for Payer: Mclaren Commercial |
$169.25
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.85
|
| Rate for Payer: Nomi Health Commercial |
$154.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.04
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$20.86
|
| Rate for Payer: PHP Medicaid |
$10.16
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.96
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.96
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$218.80 |
| Rate for Payer: Aetna Commercial |
$196.92
|
| Rate for Payer: ASR ASR |
$212.24
|
| Rate for Payer: BCBS Trust/PPO |
$179.68
|
| Rate for Payer: BCN Commercial |
$179.68
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Commercial |
$205.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Healthscope Commercial |
$212.24
|
| Rate for Payer: Healthscope Whirlpool |
$218.80
|
| Rate for Payer: Mclaren Commercial |
$196.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$179.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.54
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$218.80 |
| Rate for Payer: Aetna Commercial |
$196.92
|
| Rate for Payer: Aetna Medicare |
$122.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: ASR ASR |
$212.24
|
| Rate for Payer: BCBS Complete |
$67.12
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$180.40
|
| Rate for Payer: BCN Commercial |
$180.40
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Commercial |
$205.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$212.24
|
| Rate for Payer: Healthscope Whirlpool |
$218.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$122.22
|
| Rate for Payer: Mclaren Commercial |
$196.92
|
| Rate for Payer: Mclaren Medicaid |
$122.22
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: Meridian Medicaid |
$67.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$179.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$134.44
|
| Rate for Payer: PHP Medicaid |
$65.51
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$109.06
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow Network |
$87.25
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.22
|
| Rate for Payer: UHC Exchange |
$189.44
|
| Rate for Payer: UHC Medicaid |
$63.92
|
| Rate for Payer: UHCCP DNSP |
$122.22
|
| Rate for Payer: UHCCP Medicaid |
$63.92
|
| Rate for Payer: VA VA |
$122.22
|
|
