|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.18 |
| Max. Negotiated Rate |
$214.35 |
| Rate for Payer: Aetna Commercial |
$41.79
|
| 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 |
$45.04
|
| Rate for Payer: ASR Commercial |
$45.04
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$38.02
|
| Rate for Payer: BCN Commercial |
$36.00
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$43.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$46.43
|
| Rate for Payer: Healthscope Whirlpool |
$45.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.29
|
| Rate for Payer: Mclaren Commercial |
$41.79
|
| 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 |
$39.47
|
| Rate for Payer: Nomi Health Commercial |
$38.07
|
| 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 |
$30.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.68
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health Narrow Network |
$32.55
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.86
|
| 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 FFP UNIT
|
Facility
|
IP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.18 |
| Max. Negotiated Rate |
$46.43 |
| Rate for Payer: Aetna Commercial |
$41.79
|
| Rate for Payer: ASR ASR |
$45.04
|
| Rate for Payer: ASR Commercial |
$45.04
|
| Rate for Payer: BCBS Trust/PPO |
$37.84
|
| Rate for Payer: BCN Commercial |
$36.00
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$43.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Healthscope Commercial |
$46.43
|
| Rate for Payer: Healthscope Whirlpool |
$45.04
|
| Rate for Payer: Mclaren Commercial |
$41.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: Nomi Health Commercial |
$38.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.86
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$233.08 |
| Max. Negotiated Rate |
$358.58 |
| Rate for Payer: Aetna Commercial |
$322.72
|
| Rate for Payer: ASR ASR |
$347.82
|
| Rate for Payer: ASR Commercial |
$347.82
|
| Rate for Payer: BCBS Trust/PPO |
$292.21
|
| Rate for Payer: BCN Commercial |
$278.01
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$337.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Healthscope Commercial |
$358.58
|
| Rate for Payer: Healthscope Whirlpool |
$347.82
|
| Rate for Payer: Mclaren Commercial |
$322.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: Nomi Health Commercial |
$294.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.55
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$358.58 |
| Rate for Payer: Aetna Commercial |
$322.72
|
| 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 |
$347.82
|
| Rate for Payer: ASR Commercial |
$347.82
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$293.64
|
| Rate for Payer: BCN Commercial |
$278.01
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$337.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$358.58
|
| Rate for Payer: Healthscope Whirlpool |
$347.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.29
|
| Rate for Payer: Mclaren Commercial |
$322.72
|
| 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 |
$304.79
|
| Rate for Payer: Nomi Health Commercial |
$294.04
|
| 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 |
$233.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.19
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health Narrow Network |
$251.36
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.55
|
| 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 PSORALEN PLT UNIT
|
Facility
|
IP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$195.44 |
| Max. Negotiated Rate |
$300.68 |
| Rate for Payer: Aetna Commercial |
$270.61
|
| Rate for Payer: ASR ASR |
$291.66
|
| Rate for Payer: ASR Commercial |
$291.66
|
| Rate for Payer: BCBS Trust/PPO |
$245.02
|
| Rate for Payer: BCN Commercial |
$233.12
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$282.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Healthscope Commercial |
$300.68
|
| Rate for Payer: Healthscope Whirlpool |
$291.66
|
| Rate for Payer: Mclaren Commercial |
$270.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: Nomi Health Commercial |
$246.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.60
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$300.68 |
| Rate for Payer: Aetna Commercial |
$270.61
|
| 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 |
$291.66
|
| Rate for Payer: ASR Commercial |
$291.66
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$246.23
|
| Rate for Payer: BCN Commercial |
$233.12
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$282.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$300.68
|
| Rate for Payer: Healthscope Whirlpool |
$291.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.29
|
| Rate for Payer: Mclaren Commercial |
$270.61
|
| 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 |
$255.58
|
| Rate for Payer: Nomi Health Commercial |
$246.56
|
| 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 |
$195.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.46
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health Narrow Network |
$210.78
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.60
|
| 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 RBC UNIT
|
Facility
|
OP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$214.35 |
| Rate for Payer: Aetna Commercial |
$73.51
|
| 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 |
$79.23
|
| Rate for Payer: ASR Commercial |
$79.23
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$66.89
|
| Rate for Payer: BCN Commercial |
$63.33
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$81.68
|
| Rate for Payer: Healthscope Whirlpool |
$79.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.29
|
| Rate for Payer: Mclaren Commercial |
$73.51
|
| 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 |
$69.43
|
| Rate for Payer: Nomi Health Commercial |
$66.98
|
| 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 |
$53.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.57
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health Narrow Network |
$57.26
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.88
|
| 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 RBC UNIT
|
Facility
|
IP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$81.68 |
| Rate for Payer: Aetna Commercial |
$73.51
|
| Rate for Payer: ASR ASR |
$79.23
|
| Rate for Payer: ASR Commercial |
$79.23
|
| Rate for Payer: BCBS Trust/PPO |
$66.56
|
| Rate for Payer: BCN Commercial |
$63.33
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$81.68
|
| Rate for Payer: Healthscope Whirlpool |
$79.23
|
| Rate for Payer: Mclaren Commercial |
$73.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: Nomi Health Commercial |
$66.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.88
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$67.37 |
| Max. Negotiated Rate |
$103.65 |
| Rate for Payer: Aetna Commercial |
$93.28
|
| Rate for Payer: ASR ASR |
$100.54
|
| Rate for Payer: ASR Commercial |
$100.54
|
| Rate for Payer: BCBS Trust/PPO |
$84.46
|
| Rate for Payer: BCN Commercial |
$80.36
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$97.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Healthscope Commercial |
$103.65
|
| Rate for Payer: Healthscope Whirlpool |
$100.54
|
| Rate for Payer: Mclaren Commercial |
$93.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: Nomi Health Commercial |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.21
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$67.37 |
| Max. Negotiated Rate |
$214.35 |
| Rate for Payer: Aetna Commercial |
$93.28
|
| 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 |
$100.54
|
| Rate for Payer: ASR Commercial |
$100.54
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$84.88
|
| Rate for Payer: BCN Commercial |
$80.36
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$97.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$103.65
|
| Rate for Payer: Healthscope Whirlpool |
$100.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.29
|
| Rate for Payer: Mclaren Commercial |
$93.28
|
| 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 |
$88.10
|
| Rate for Payer: Nomi Health Commercial |
$84.99
|
| 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 |
$67.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.82
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health Narrow Network |
$72.66
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.21
|
| 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 TYPING RH
|
Facility
|
OP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$22.27 |
| Rate for Payer: Aetna Commercial |
$20.04
|
| Rate for Payer: Aetna Medicare |
$2.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.74
|
| Rate for Payer: ASR ASR |
$21.60
|
| Rate for Payer: ASR Commercial |
$21.60
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCBS Trust/PPO |
$18.24
|
| Rate for Payer: BCN Commercial |
$17.27
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$20.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Healthscope Whirlpool |
$21.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.99
|
| Rate for Payer: Mclaren Commercial |
$20.04
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Mclaren Medicare |
$2.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: PACE Medicare |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: PHP Medicaid |
$1.60
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.51
|
| Rate for Payer: Priority Health Medicare |
$2.99
|
| Rate for Payer: Priority Health Narrow Network |
$15.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.99
|
| Rate for Payer: UHC Exchange |
$4.63
|
| Rate for Payer: UHC Medicare Advantage |
$2.99
|
| Rate for Payer: UHCCP DNSP |
$2.99
|
| Rate for Payer: UHCCP Medicaid |
$1.60
|
| Rate for Payer: VA VA |
$2.99
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$22.27 |
| Rate for Payer: Aetna Commercial |
$20.04
|
| Rate for Payer: ASR ASR |
$21.60
|
| Rate for Payer: ASR Commercial |
$21.60
|
| Rate for Payer: BCBS Trust/PPO |
$18.15
|
| Rate for Payer: BCN Commercial |
$17.27
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$20.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Healthscope Whirlpool |
$21.60
|
| Rate for Payer: Mclaren Commercial |
$20.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.60
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$117.68 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: Aetna Medicare |
$219.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.45
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: ASR Commercial |
$1,484.10
|
| Rate for Payer: BCBS Complete |
$123.57
|
| Rate for Payer: BCBS MAPPO |
$219.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.92
|
| Rate for Payer: BCN Commercial |
$1,186.21
|
| Rate for Payer: BCN Medicare Advantage |
$219.56
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.56
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$219.56
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Mclaren Medicaid |
$117.68
|
| Rate for Payer: Mclaren Medicare |
$219.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.54
|
| Rate for Payer: Meridian Medicaid |
$123.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: PACE Medicare |
$208.58
|
| Rate for Payer: PACE SWMI |
$219.56
|
| Rate for Payer: PHP Commercial |
$241.52
|
| Rate for Payer: PHP Medicaid |
$117.68
|
| Rate for Payer: PHP Medicare Advantage |
$219.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,340.59
|
| Rate for Payer: Priority Health Medicare |
$219.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,072.53
|
| Rate for Payer: Railroad Medicare Medicare |
$219.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.56
|
| Rate for Payer: UHC Exchange |
$340.32
|
| Rate for Payer: UHC Medicare Advantage |
$219.56
|
| Rate for Payer: UHCCP DNSP |
$219.56
|
| Rate for Payer: UHCCP Medicaid |
$117.68
|
| Rate for Payer: VA VA |
$219.56
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$994.50 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: ASR Commercial |
$1,484.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.80
|
| Rate for Payer: BCN Commercial |
$1,186.21
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.10
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.04 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$138.80
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: ASR ASR |
$149.59
|
| Rate for Payer: ASR Commercial |
$149.59
|
| Rate for Payer: BCBS Complete |
$22.10
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$126.29
|
| Rate for Payer: BCN Commercial |
$119.57
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Healthscope Whirlpool |
$149.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$39.26
|
| Rate for Payer: Mclaren Commercial |
$138.80
|
| Rate for Payer: Mclaren Medicaid |
$21.04
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$22.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$43.19
|
| Rate for Payer: PHP Medicaid |
$21.04
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.13
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$108.11
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.26
|
| Rate for Payer: UHC Exchange |
$60.85
|
| Rate for Payer: UHC Medicare Advantage |
$39.26
|
| Rate for Payer: UHCCP DNSP |
$39.26
|
| Rate for Payer: UHCCP Medicaid |
$21.04
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.24 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$138.80
|
| Rate for Payer: ASR ASR |
$149.59
|
| Rate for Payer: ASR Commercial |
$149.59
|
| Rate for Payer: BCBS Trust/PPO |
$125.67
|
| Rate for Payer: BCN Commercial |
$119.57
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Healthscope Whirlpool |
$149.59
|
| Rate for Payer: Mclaren Commercial |
$138.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.71
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,323.03 |
| Max. Negotiated Rate |
$2,035.43 |
| Rate for Payer: Aetna Commercial |
$1,831.89
|
| Rate for Payer: ASR ASR |
$1,974.37
|
| Rate for Payer: ASR Commercial |
$1,974.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.67
|
| Rate for Payer: BCN Commercial |
$1,578.07
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,913.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$2,035.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.37
|
| Rate for Payer: Mclaren Commercial |
$1,831.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: Nomi Health Commercial |
$1,669.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,791.18
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$814.17 |
| Max. Negotiated Rate |
$2,035.43 |
| Rate for Payer: Aetna Commercial |
$1,831.89
|
| Rate for Payer: Aetna Medicare |
$1,017.72
|
| Rate for Payer: ASR ASR |
$1,974.37
|
| Rate for Payer: ASR Commercial |
$1,974.37
|
| Rate for Payer: BCBS Complete |
$814.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,666.81
|
| Rate for Payer: BCN Commercial |
$1,578.07
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,913.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$2,035.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.37
|
| Rate for Payer: Mclaren Commercial |
$1,831.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: Nomi Health Commercial |
$1,669.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,783.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,426.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,791.18
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,409.14 |
| Max. Negotiated Rate |
$2,167.91 |
| Rate for Payer: Aetna Commercial |
$1,951.12
|
| Rate for Payer: ASR ASR |
$2,102.87
|
| Rate for Payer: ASR Commercial |
$2,102.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,766.63
|
| Rate for Payer: BCN Commercial |
$1,680.78
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$2,037.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Healthscope Commercial |
$2,167.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,102.87
|
| Rate for Payer: Mclaren Commercial |
$1,951.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: Nomi Health Commercial |
$1,777.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,907.76
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,951.12
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$2,102.87
|
| Rate for Payer: ASR Commercial |
$2,102.87
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.30
|
| Rate for Payer: BCN Commercial |
$1,680.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$2,037.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,167.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,102.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,951.12
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: Nomi Health Commercial |
$1,777.69
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,899.52
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,519.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,907.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,858.20
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$2,002.73
|
| Rate for Payer: ASR Commercial |
$2,002.73
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.76
|
| Rate for Payer: BCN Commercial |
$1,600.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,940.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,858.20
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,809.06
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,447.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,342.04 |
| Max. Negotiated Rate |
$2,064.67 |
| Rate for Payer: Aetna Commercial |
$1,858.20
|
| Rate for Payer: ASR ASR |
$2,002.73
|
| Rate for Payer: ASR Commercial |
$2,002.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.50
|
| Rate for Payer: BCN Commercial |
$1,600.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,940.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.73
|
| Rate for Payer: Mclaren Commercial |
$1,858.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.91
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,578.87 |
| Max. Negotiated Rate |
$2,429.03 |
| Rate for Payer: Aetna Commercial |
$2,186.13
|
| Rate for Payer: ASR ASR |
$2,356.16
|
| Rate for Payer: ASR Commercial |
$2,356.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.42
|
| Rate for Payer: BCN Commercial |
$1,883.23
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,283.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,429.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,356.16
|
| Rate for Payer: Mclaren Commercial |
$2,186.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,137.55
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$2,186.13
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$2,356.16
|
| Rate for Payer: ASR Commercial |
$2,356.16
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.13
|
| Rate for Payer: BCN Commercial |
$1,883.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,283.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,429.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,356.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$2,186.13
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,128.32
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,702.75
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,137.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.02 |
| Max. Negotiated Rate |
$1,234.90 |
| Rate for Payer: Aetna Commercial |
$150.96
|
| Rate for Payer: Aetna Medicare |
$796.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: ASR ASR |
$162.70
|
| Rate for Payer: ASR Commercial |
$162.70
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCBS Trust/PPO |
$137.35
|
| Rate for Payer: BCN Commercial |
$130.04
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$157.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$167.73
|
| Rate for Payer: Healthscope Whirlpool |
$162.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$796.71
|
| Rate for Payer: Mclaren Commercial |
$150.96
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$876.38
|
| Rate for Payer: PHP Medicaid |
$427.04
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.97
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health Narrow Network |
$117.58
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Exchange |
$1,234.90
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP DNSP |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$427.04
|
| Rate for Payer: VA VA |
$796.71
|
|
