|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$194.55
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$194.55 |
| Rate for Payer: Aetna Commercial |
$175.09
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: ASR ASR |
$188.71
|
| Rate for Payer: BCBS Complete |
$14.17
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$160.41
|
| Rate for Payer: BCN Commercial |
$160.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cofinity Commercial |
$182.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$188.71
|
| Rate for Payer: Healthscope Whirlpool |
$194.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.81
|
| Rate for Payer: Mclaren Commercial |
$175.09
|
| Rate for Payer: Mclaren Medicaid |
$25.81
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$14.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.37
|
| Rate for Payer: Nomi Health Commercial |
$159.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.91
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$28.39
|
| Rate for Payer: PHP Medicaid |
$13.83
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.79
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$91.03
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.81
|
| Rate for Payer: UHC Exchange |
$40.01
|
| Rate for Payer: UHC Medicaid |
$13.50
|
| Rate for Payer: UHCCP DNSP |
$25.81
|
| Rate for Payer: UHCCP Medicaid |
$13.50
|
| Rate for Payer: VA VA |
$25.81
|
|
|
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
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
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
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
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 DISEASE CASCADE
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$28.11
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$23.89
|
| Rate for Payer: BCN Commercial |
$23.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$28.11
|
| Rate for Payer: Healthscope Whirlpool |
$28.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$26.08
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$28.98 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: ASR ASR |
$28.11
|
| Rate for Payer: BCBS Trust/PPO |
$23.80
|
| Rate for Payer: BCN Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.11
|
| Rate for Payer: Healthscope Whirlpool |
$28.98
|
| Rate for Payer: Mclaren Commercial |
$26.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.50
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$28.11
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$23.89
|
| Rate for Payer: BCN Commercial |
$23.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$28.11
|
| Rate for Payer: Healthscope Whirlpool |
$28.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$26.08
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$28.98 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: ASR ASR |
$28.11
|
| Rate for Payer: BCBS Trust/PPO |
$23.80
|
| Rate for Payer: BCN Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.11
|
| Rate for Payer: Healthscope Whirlpool |
$28.98
|
| Rate for Payer: Mclaren Commercial |
$26.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.50
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,366.00 |
| Rate for Payer: Aetna Commercial |
$1,111.95
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,198.43
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.67
|
| Rate for Payer: BCN Commercial |
$1,018.67
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Commercial |
$1,161.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,198.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,235.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$1,111.95
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Nomi Health Commercial |
$1,013.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,082.55
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$866.09
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,087.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$926.62 |
| Max. Negotiated Rate |
$1,235.50 |
| Rate for Payer: Aetna Commercial |
$1,111.95
|
| Rate for Payer: ASR ASR |
$1,198.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.59
|
| Rate for Payer: BCN Commercial |
$1,014.59
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Commercial |
$1,161.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Healthscope Commercial |
$1,198.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,235.50
|
| Rate for Payer: Mclaren Commercial |
$1,111.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Nomi Health Commercial |
$1,013.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,087.24
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$174.79 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.57
|
| Rate for Payer: ASR ASR |
$169.55
|
| Rate for Payer: BCBS Complete |
$6.84
|
| Rate for Payer: BCBS MAPPO |
$12.46
|
| Rate for Payer: BCBS Trust/PPO |
$144.11
|
| Rate for Payer: BCN Commercial |
$144.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.46
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$164.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.46
|
| Rate for Payer: Healthscope Commercial |
$169.55
|
| Rate for Payer: Healthscope Whirlpool |
$174.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.46
|
| Rate for Payer: Mclaren Commercial |
$157.31
|
| Rate for Payer: Mclaren Medicaid |
$12.46
|
| Rate for Payer: Mclaren Medicare |
$12.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.08
|
| Rate for Payer: Meridian Medicaid |
$6.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: PACE Medicare |
$11.84
|
| Rate for Payer: PACE SWMI |
$12.46
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Medicaid |
$6.68
|
| Rate for Payer: PHP Medicare Advantage |
$12.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.15
|
| Rate for Payer: Priority Health Medicare |
$12.46
|
| Rate for Payer: Priority Health Narrow Network |
$122.53
|
| Rate for Payer: Railroad Medicare Medicare |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.46
|
| Rate for Payer: UHC Exchange |
$19.31
|
| Rate for Payer: UHC Medicaid |
$6.52
|
| Rate for Payer: UHCCP DNSP |
$12.46
|
| Rate for Payer: UHCCP Medicaid |
$6.52
|
| Rate for Payer: VA VA |
$12.46
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$131.09 |
| Max. Negotiated Rate |
$174.79 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: ASR ASR |
$169.55
|
| Rate for Payer: BCBS Trust/PPO |
$143.54
|
| Rate for Payer: BCN Commercial |
$143.54
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$164.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$169.55
|
| Rate for Payer: Healthscope Whirlpool |
$174.79
|
| Rate for Payer: Mclaren Commercial |
$157.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.82
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna Commercial |
$84.64
|
| Rate for Payer: Aetna Medicare |
$5.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.00
|
| Rate for Payer: ASR ASR |
$91.23
|
| Rate for Payer: BCBS Complete |
$3.08
|
| Rate for Payer: BCBS MAPPO |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$77.54
|
| Rate for Payer: BCN Commercial |
$77.54
|
| Rate for Payer: BCN Medicare Advantage |
$5.60
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$88.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.60
|
| Rate for Payer: Healthscope Commercial |
$91.23
|
| Rate for Payer: Healthscope Whirlpool |
$94.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.60
|
| Rate for Payer: Mclaren Commercial |
$84.64
|
| Rate for Payer: Mclaren Medicaid |
$5.60
|
| Rate for Payer: Mclaren Medicare |
$5.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.88
|
| Rate for Payer: Meridian Medicaid |
$3.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Medicare |
$5.32
|
| Rate for Payer: PACE SWMI |
$5.60
|
| Rate for Payer: PHP Commercial |
$6.16
|
| Rate for Payer: PHP Medicaid |
$3.00
|
| Rate for Payer: PHP Medicare Advantage |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.02
|
| Rate for Payer: Priority Health Medicare |
$5.60
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.60
|
| Rate for Payer: UHC Exchange |
$8.68
|
| Rate for Payer: UHC Medicaid |
$2.93
|
| Rate for Payer: UHCCP DNSP |
$5.60
|
| Rate for Payer: UHCCP Medicaid |
$2.93
|
| Rate for Payer: VA VA |
$5.60
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$70.54 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna Commercial |
$84.64
|
| Rate for Payer: ASR ASR |
$91.23
|
| Rate for Payer: BCBS Trust/PPO |
$77.23
|
| Rate for Payer: BCN Commercial |
$77.23
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$88.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$91.23
|
| Rate for Payer: Healthscope Whirlpool |
$94.05
|
| Rate for Payer: Mclaren Commercial |
$84.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.76
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$268.22
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.05 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$241.40
|
| Rate for Payer: Aetna Medicare |
$135.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.82
|
| Rate for Payer: ASR ASR |
$260.17
|
| Rate for Payer: BCBS Complete |
$74.61
|
| Rate for Payer: BCBS MAPPO |
$135.86
|
| Rate for Payer: BCBS Trust/PPO |
$221.15
|
| Rate for Payer: BCN Commercial |
$221.15
|
| Rate for Payer: BCN Medicare Advantage |
$135.86
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cofinity Commercial |
$252.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$260.17
|
| Rate for Payer: Healthscope Whirlpool |
$268.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$135.86
|
| Rate for Payer: Mclaren Commercial |
$241.40
|
| Rate for Payer: Mclaren Medicaid |
$135.86
|
| Rate for Payer: Mclaren Medicare |
$135.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.65
|
| Rate for Payer: Meridian Medicaid |
$74.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.99
|
| Rate for Payer: Nomi Health Commercial |
$219.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.16
|
| Rate for Payer: PACE Medicare |
$129.07
|
| Rate for Payer: PACE SWMI |
$135.86
|
| Rate for Payer: PHP Commercial |
$149.45
|
| Rate for Payer: PHP Medicaid |
$72.82
|
| Rate for Payer: PHP Medicare Advantage |
$135.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$235.01
|
| Rate for Payer: Priority Health Medicare |
$135.86
|
| Rate for Payer: Priority Health Narrow Network |
$188.02
|
| Rate for Payer: Railroad Medicare Medicare |
$135.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.86
|
| Rate for Payer: UHC Exchange |
$210.58
|
| Rate for Payer: UHC Medicaid |
$71.05
|
| Rate for Payer: UHCCP DNSP |
$135.86
|
| Rate for Payer: UHCCP Medicaid |
$71.05
|
| Rate for Payer: VA VA |
$135.86
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$268.22
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$201.16 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$241.40
|
| Rate for Payer: ASR ASR |
$260.17
|
| Rate for Payer: BCBS Trust/PPO |
$220.26
|
| Rate for Payer: BCN Commercial |
$220.26
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cofinity Commercial |
$252.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.58
|
| Rate for Payer: Healthscope Commercial |
$260.17
|
| Rate for Payer: Healthscope Whirlpool |
$268.22
|
| Rate for Payer: Mclaren Commercial |
$241.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.99
|
| Rate for Payer: Nomi Health Commercial |
$219.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.03
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.14 |
| Max. Negotiated Rate |
$148.19 |
| Rate for Payer: Aetna Commercial |
$133.37
|
| Rate for Payer: ASR ASR |
$143.74
|
| Rate for Payer: BCBS Trust/PPO |
$121.69
|
| Rate for Payer: BCN Commercial |
$121.69
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$139.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Healthscope Whirlpool |
$148.19
|
| Rate for Payer: Mclaren Commercial |
$133.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.41
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$148.19 |
| Rate for Payer: Aetna Commercial |
$133.37
|
| Rate for Payer: Aetna Medicare |
$54.83
|
| Rate for Payer: ASR ASR |
$143.74
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS Trust/PPO |
$122.18
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$122.18
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$139.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Healthscope Whirlpool |
$148.19
|
| Rate for Payer: Mclaren Commercial |
$133.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.41
|
|
|
HC CENTRIFUGAL HEAD
|
Facility
|
OP
|
$414.48
|
|
| Hospital Charge Code |
27006714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$153.36 |
| Max. Negotiated Rate |
$414.48 |
| Rate for Payer: Aetna Commercial |
$373.03
|
| Rate for Payer: Aetna Medicare |
$153.36
|
| Rate for Payer: ASR ASR |
$402.05
|
| Rate for Payer: BCBS Complete |
$165.79
|
| Rate for Payer: BCBS Trust/PPO |
$341.74
|
| Rate for Payer: BCN Commercial |
$341.74
|
| Rate for Payer: Cash Price |
$331.58
|
| Rate for Payer: Cofinity Commercial |
$389.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.58
|
| Rate for Payer: Healthscope Commercial |
$402.05
|
| Rate for Payer: Healthscope Whirlpool |
$414.48
|
| Rate for Payer: Mclaren Commercial |
$373.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.31
|
| Rate for Payer: Nomi Health Commercial |
$339.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$363.17
|
| Rate for Payer: Priority Health Narrow Network |
$290.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.74
|
|
|
HC CENTRIFUGAL HEAD
|
Facility
|
IP
|
$414.48
|
|
| Hospital Charge Code |
27006714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$310.86 |
| Max. Negotiated Rate |
$414.48 |
| Rate for Payer: Aetna Commercial |
$373.03
|
| Rate for Payer: ASR ASR |
$402.05
|
| Rate for Payer: BCBS Trust/PPO |
$340.37
|
| Rate for Payer: BCN Commercial |
$340.37
|
| Rate for Payer: Cash Price |
$331.58
|
| Rate for Payer: Cofinity Commercial |
$389.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.58
|
| Rate for Payer: Healthscope Commercial |
$402.05
|
| Rate for Payer: Healthscope Whirlpool |
$414.48
|
| Rate for Payer: Mclaren Commercial |
$373.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.31
|
| Rate for Payer: Nomi Health Commercial |
$339.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.74
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$29.57
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$29.46
|
| Rate for Payer: BCN Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.31 |
| Max. Negotiated Rate |
$254.90 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: Aetna Medicare |
$94.31
|
| Rate for Payer: ASR ASR |
$247.25
|
| Rate for Payer: BCBS Complete |
$101.96
|
| Rate for Payer: BCBS Trust/PPO |
$210.17
|
| Rate for Payer: BCN Commercial |
$210.17
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$239.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$247.25
|
| Rate for Payer: Healthscope Whirlpool |
$254.90
|
| Rate for Payer: Mclaren Commercial |
$229.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$223.34
|
| Rate for Payer: Priority Health Narrow Network |
$178.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.31
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$191.18 |
| Max. Negotiated Rate |
$254.90 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: ASR ASR |
$247.25
|
| Rate for Payer: BCBS Trust/PPO |
$209.32
|
| Rate for Payer: BCN Commercial |
$209.32
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$239.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$247.25
|
| Rate for Payer: Healthscope Whirlpool |
$254.90
|
| Rate for Payer: Mclaren Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.31
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,218.68
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,164.01 |
| Max. Negotiated Rate |
$4,218.68 |
| Rate for Payer: Aetna Commercial |
$3,796.81
|
| Rate for Payer: ASR ASR |
$4,092.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,464.38
|
| Rate for Payer: BCN Commercial |
$3,464.38
|
| Rate for Payer: Cash Price |
$3,374.94
|
| Rate for Payer: Cofinity Commercial |
$3,965.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.94
|
| Rate for Payer: Healthscope Commercial |
$4,092.12
|
| Rate for Payer: Healthscope Whirlpool |
$4,218.68
|
| Rate for Payer: Mclaren Commercial |
$3,796.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.88
|
| Rate for Payer: Nomi Health Commercial |
$3,459.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,164.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,712.44
|
|
