|
HC BLADDER SCAN
|
Facility
|
IP
|
$153.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.54 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: ASR ASR |
$148.55
|
| Rate for Payer: ASR Commercial |
$148.55
|
| Rate for Payer: BCBS Trust/PPO |
$124.79
|
| Rate for Payer: BCN Commercial |
$118.73
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cofinity Commercial |
$143.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.51
|
| Rate for Payer: Healthscope Commercial |
$153.14
|
| Rate for Payer: Healthscope Whirlpool |
$148.55
|
| Rate for Payer: Mclaren Commercial |
$137.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$125.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.76
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.91 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$7.26
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.90
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$6.91
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$7.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: PHP Medicaid |
$6.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.90
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.90
|
| Rate for Payer: UHCCP DNSP |
$12.90
|
| Rate for Payer: UHCCP Medicaid |
$6.91
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$124.52
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$124.52 |
| Rate for Payer: Aetna Commercial |
$112.07
|
| Rate for Payer: ASR ASR |
$120.78
|
| Rate for Payer: ASR Commercial |
$120.78
|
| Rate for Payer: BCBS Trust/PPO |
$101.47
|
| Rate for Payer: BCN Commercial |
$96.54
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.62
|
| Rate for Payer: Healthscope Commercial |
$124.52
|
| Rate for Payer: Healthscope Whirlpool |
$120.78
|
| Rate for Payer: Mclaren Commercial |
$112.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.84
|
| Rate for Payer: Nomi Health Commercial |
$102.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.58
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$124.52
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$112.07
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$120.78
|
| Rate for Payer: ASR Commercial |
$120.78
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$101.97
|
| Rate for Payer: BCN Commercial |
$96.54
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$124.52
|
| Rate for Payer: Healthscope Whirlpool |
$120.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$112.07
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.84
|
| Rate for Payer: Nomi Health Commercial |
$102.11
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.10
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$87.29
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.67
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.03
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Complete |
$2.71
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.82
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Mclaren Medicaid |
$2.58
|
| Rate for Payer: Mclaren Medicare |
$4.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: Meridian Medicaid |
$2.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Medicare |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: PHP Medicaid |
$2.58
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.39
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow Network |
$53.91
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.82
|
| Rate for Payer: UHC Exchange |
$7.47
|
| Rate for Payer: UHC Medicare Advantage |
$4.82
|
| Rate for Payer: UHCCP DNSP |
$4.82
|
| Rate for Payer: UHCCP Medicaid |
$2.58
|
| Rate for Payer: VA VA |
$4.82
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$97.70
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$97.70 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$94.77
|
| Rate for Payer: ASR Commercial |
$94.77
|
| Rate for Payer: BCBS Complete |
$5.81
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$80.01
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cofinity Commercial |
$91.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$97.70
|
| Rate for Payer: Healthscope Whirlpool |
$94.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$87.93
|
| Rate for Payer: Mclaren Medicaid |
$5.53
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.05
|
| Rate for Payer: Nomi Health Commercial |
$80.11
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.53
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.60
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$68.49
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.32
|
| Rate for Payer: UHC Exchange |
$16.00
|
| Rate for Payer: UHC Medicare Advantage |
$10.32
|
| Rate for Payer: UHCCP DNSP |
$10.32
|
| Rate for Payer: UHCCP Medicaid |
$5.53
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$97.70
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.51 |
| Max. Negotiated Rate |
$97.70 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: ASR ASR |
$94.77
|
| Rate for Payer: ASR Commercial |
$94.77
|
| Rate for Payer: BCBS Trust/PPO |
$79.62
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cofinity Commercial |
$91.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.16
|
| Rate for Payer: Healthscope Commercial |
$97.70
|
| Rate for Payer: Healthscope Whirlpool |
$94.77
|
| Rate for Payer: Mclaren Commercial |
$87.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.05
|
| Rate for Payer: Nomi Health Commercial |
$80.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.98
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$167.77
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$150.99
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$162.74
|
| Rate for Payer: ASR Commercial |
$162.74
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$137.39
|
| Rate for Payer: BCN Commercial |
$130.07
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Commercial |
$157.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$167.77
|
| Rate for Payer: Healthscope Whirlpool |
$162.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$150.99
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Nomi Health Commercial |
$137.57
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.00
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$117.61
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$167.77
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.05 |
| Max. Negotiated Rate |
$167.77 |
| Rate for Payer: Aetna Commercial |
$150.99
|
| Rate for Payer: ASR ASR |
$162.74
|
| Rate for Payer: ASR Commercial |
$162.74
|
| Rate for Payer: BCBS Trust/PPO |
$136.72
|
| Rate for Payer: BCN Commercial |
$130.07
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Commercial |
$157.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Healthscope Commercial |
$167.77
|
| Rate for Payer: Healthscope Whirlpool |
$162.74
|
| Rate for Payer: Mclaren Commercial |
$150.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Nomi Health Commercial |
$137.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.64
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$176.97
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.03 |
| Max. Negotiated Rate |
$176.97 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: ASR ASR |
$171.66
|
| Rate for Payer: ASR Commercial |
$171.66
|
| Rate for Payer: BCBS Trust/PPO |
$144.21
|
| Rate for Payer: BCN Commercial |
$137.20
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$166.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Healthscope Commercial |
$176.97
|
| Rate for Payer: Healthscope Whirlpool |
$171.66
|
| Rate for Payer: Mclaren Commercial |
$159.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.73
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$176.97
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.97 |
| Max. Negotiated Rate |
$176.97 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna Medicare |
$26.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.59
|
| Rate for Payer: ASR ASR |
$171.66
|
| Rate for Payer: ASR Commercial |
$171.66
|
| Rate for Payer: BCBS Complete |
$14.67
|
| Rate for Payer: BCBS MAPPO |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$144.92
|
| Rate for Payer: BCN Commercial |
$137.20
|
| Rate for Payer: BCN Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$166.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$176.97
|
| Rate for Payer: Healthscope Whirlpool |
$171.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.07
|
| Rate for Payer: Mclaren Commercial |
$159.27
|
| Rate for Payer: Mclaren Medicaid |
$13.97
|
| Rate for Payer: Mclaren Medicare |
$26.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.37
|
| Rate for Payer: Meridian Medicaid |
$14.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PACE Medicare |
$24.77
|
| Rate for Payer: PACE SWMI |
$26.07
|
| Rate for Payer: PHP Commercial |
$28.68
|
| Rate for Payer: PHP Medicaid |
$13.97
|
| Rate for Payer: PHP Medicare Advantage |
$26.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.06
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health Narrow Network |
$124.06
|
| Rate for Payer: Railroad Medicare Medicare |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.07
|
| Rate for Payer: UHC Exchange |
$40.41
|
| Rate for Payer: UHC Medicare Advantage |
$26.07
|
| Rate for Payer: UHCCP DNSP |
$26.07
|
| Rate for Payer: UHCCP Medicaid |
$13.97
|
| Rate for Payer: VA VA |
$26.07
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$122.20 |
| Max. Negotiated Rate |
$188.00 |
| Rate for Payer: Aetna Commercial |
$169.20
|
| Rate for Payer: ASR ASR |
$182.36
|
| Rate for Payer: ASR Commercial |
$182.36
|
| Rate for Payer: BCBS Trust/PPO |
$153.20
|
| Rate for Payer: BCN Commercial |
$145.76
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Healthscope Commercial |
$188.00
|
| Rate for Payer: Healthscope Whirlpool |
$182.36
|
| Rate for Payer: Mclaren Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.44
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.22 |
| Max. Negotiated Rate |
$188.00 |
| Rate for Payer: Aetna Commercial |
$169.20
|
| Rate for Payer: Aetna Medicare |
$78.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: ASR ASR |
$182.36
|
| Rate for Payer: ASR Commercial |
$182.36
|
| Rate for Payer: BCBS Complete |
$44.33
|
| Rate for Payer: BCBS MAPPO |
$78.77
|
| Rate for Payer: BCBS Trust/PPO |
$153.95
|
| Rate for Payer: BCN Commercial |
$145.76
|
| Rate for Payer: BCN Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.77
|
| Rate for Payer: Healthscope Commercial |
$188.00
|
| Rate for Payer: Healthscope Whirlpool |
$182.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$78.77
|
| Rate for Payer: Mclaren Commercial |
$169.20
|
| Rate for Payer: Mclaren Medicaid |
$42.22
|
| Rate for Payer: Mclaren Medicare |
$78.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.71
|
| Rate for Payer: Meridian Medicaid |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: PACE Medicare |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.77
|
| Rate for Payer: PHP Commercial |
$86.65
|
| Rate for Payer: PHP Medicaid |
$42.22
|
| Rate for Payer: PHP Medicare Advantage |
$78.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.73
|
| Rate for Payer: Priority Health Medicare |
$78.77
|
| Rate for Payer: Priority Health Narrow Network |
$131.79
|
| Rate for Payer: Railroad Medicare Medicare |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.77
|
| Rate for Payer: UHC Exchange |
$122.09
|
| Rate for Payer: UHC Medicare Advantage |
$78.77
|
| Rate for Payer: UHCCP DNSP |
$78.77
|
| Rate for Payer: UHCCP Medicaid |
$42.22
|
| Rate for Payer: VA VA |
$78.77
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
OP
|
$31.29
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$31.29 |
| Rate for Payer: Aetna Commercial |
$28.16
|
| Rate for Payer: Aetna Medicare |
$18.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: ASR ASR |
$30.35
|
| Rate for Payer: ASR Commercial |
$30.35
|
| Rate for Payer: BCBS Complete |
$10.16
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$25.62
|
| Rate for Payer: BCN Commercial |
$24.26
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$29.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$31.29
|
| Rate for Payer: Healthscope Whirlpool |
$30.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.05
|
| Rate for Payer: Mclaren Commercial |
$28.16
|
| Rate for Payer: Mclaren Medicaid |
$9.67
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: Meridian Medicaid |
$10.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Nomi Health Commercial |
$25.66
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$19.86
|
| Rate for Payer: PHP Medicaid |
$9.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.42
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$21.93
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Exchange |
$27.98
|
| Rate for Payer: UHC Medicare Advantage |
$18.05
|
| Rate for Payer: UHCCP DNSP |
$18.05
|
| Rate for Payer: UHCCP Medicaid |
$9.67
|
| Rate for Payer: VA VA |
$18.05
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
IP
|
$31.29
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$31.29 |
| Rate for Payer: Aetna Commercial |
$28.16
|
| Rate for Payer: ASR ASR |
$30.35
|
| Rate for Payer: ASR Commercial |
$30.35
|
| Rate for Payer: BCBS Trust/PPO |
$25.50
|
| Rate for Payer: BCN Commercial |
$24.26
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$29.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Healthscope Commercial |
$31.29
|
| Rate for Payer: Healthscope Whirlpool |
$30.35
|
| Rate for Payer: Mclaren Commercial |
$28.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Nomi Health Commercial |
$25.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.54
|
|
|
HC BLOOD PATCH
|
Facility
|
OP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,212.51 |
| Rate for Payer: Aetna Commercial |
$1,091.26
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$1,176.13
|
| Rate for Payer: ASR Commercial |
$1,176.13
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$992.92
|
| Rate for Payer: BCN Commercial |
$940.06
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,139.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,212.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$1,091.26
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.40
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$849.97
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC BLOOD PATCH
|
Facility
|
IP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.13 |
| Max. Negotiated Rate |
$1,212.51 |
| Rate for Payer: Aetna Commercial |
$1,091.26
|
| Rate for Payer: ASR ASR |
$1,176.13
|
| Rate for Payer: ASR Commercial |
$1,176.13
|
| Rate for Payer: BCBS Trust/PPO |
$988.07
|
| Rate for Payer: BCN Commercial |
$940.06
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,139.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Healthscope Commercial |
$1,212.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.13
|
| Rate for Payer: Mclaren Commercial |
$1,091.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.01
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
OP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,212.51 |
| Rate for Payer: Aetna Commercial |
$1,091.26
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$1,176.13
|
| Rate for Payer: ASR Commercial |
$1,176.13
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$992.92
|
| Rate for Payer: BCN Commercial |
$940.06
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,139.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,212.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$1,091.26
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.40
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$849.97
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
IP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.13 |
| Max. Negotiated Rate |
$1,212.51 |
| Rate for Payer: Aetna Commercial |
$1,091.26
|
| Rate for Payer: ASR ASR |
$1,176.13
|
| Rate for Payer: ASR Commercial |
$1,176.13
|
| Rate for Payer: BCBS Trust/PPO |
$988.07
|
| Rate for Payer: BCN Commercial |
$940.06
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,139.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Healthscope Commercial |
$1,212.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.13
|
| Rate for Payer: Mclaren Commercial |
$1,091.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.01
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
IP
|
$23.05
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.98 |
| Max. Negotiated Rate |
$23.05 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: ASR ASR |
$22.36
|
| Rate for Payer: ASR Commercial |
$22.36
|
| Rate for Payer: BCBS Trust/PPO |
$18.78
|
| Rate for Payer: BCN Commercial |
$17.87
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$21.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.44
|
| Rate for Payer: Healthscope Commercial |
$23.05
|
| Rate for Payer: Healthscope Whirlpool |
$22.36
|
| Rate for Payer: Mclaren Commercial |
$20.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.59
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.28
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
OP
|
$23.05
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$23.05 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna Medicare |
$3.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.29
|
| Rate for Payer: ASR ASR |
$22.36
|
| Rate for Payer: ASR Commercial |
$22.36
|
| Rate for Payer: BCBS Complete |
$1.93
|
| Rate for Payer: BCBS MAPPO |
$3.43
|
| Rate for Payer: BCBS Trust/PPO |
$18.88
|
| Rate for Payer: BCN Commercial |
$17.87
|
| Rate for Payer: BCN Medicare Advantage |
$3.43
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$21.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.43
|
| Rate for Payer: Healthscope Commercial |
$23.05
|
| Rate for Payer: Healthscope Whirlpool |
$22.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.43
|
| Rate for Payer: Mclaren Commercial |
$20.75
|
| Rate for Payer: Mclaren Medicaid |
$1.84
|
| Rate for Payer: Mclaren Medicare |
$3.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.60
|
| Rate for Payer: Meridian Medicaid |
$1.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.59
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: PACE Medicare |
$3.26
|
| Rate for Payer: PACE SWMI |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.77
|
| Rate for Payer: PHP Medicaid |
$1.84
|
| Rate for Payer: PHP Medicare Advantage |
$3.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.20
|
| Rate for Payer: Priority Health Medicare |
$3.43
|
| Rate for Payer: Priority Health Narrow Network |
$16.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.43
|
| Rate for Payer: UHC Exchange |
$5.32
|
| Rate for Payer: UHC Medicare Advantage |
$3.43
|
| Rate for Payer: UHCCP DNSP |
$3.43
|
| Rate for Payer: UHCCP Medicaid |
$1.84
|
| Rate for Payer: VA VA |
$3.43
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$138.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.86
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.29
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Mclaren Medicare |
$138.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$131.38
|
| Rate for Payer: PACE SWMI |
$138.29
|
| Rate for Payer: PHP Commercial |
$152.12
|
| Rate for Payer: PHP Medicaid |
$74.12
|
| Rate for Payer: PHP Medicare Advantage |
$138.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.00
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health Narrow Network |
$174.41
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.29
|
| Rate for Payer: UHC Exchange |
$214.35
|
| Rate for Payer: UHC Medicare Advantage |
$138.29
|
| Rate for Payer: UHCCP DNSP |
$138.29
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: VA VA |
$138.29
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
