|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
OP
|
$89.66
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$62.76 |
| Max. Negotiated Rate |
$177.15 |
| Rate for Payer: Aetna Commercial |
$80.69
|
| Rate for Payer: Aetna Medicare |
$141.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.15
|
| Rate for Payer: ASR ASR |
$86.97
|
| Rate for Payer: BCBS Complete |
$81.40
|
| Rate for Payer: BCBS MAPPO |
$141.72
|
| Rate for Payer: BCBS Trust/PPO |
$69.51
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$141.72
|
| Rate for Payer: Cash Price |
$71.73
|
| Rate for Payer: Cash Price |
$71.73
|
| Rate for Payer: Cofinity Commercial |
$84.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.72
|
| Rate for Payer: Healthscope Commercial |
$89.66
|
| Rate for Payer: Healthscope Whirlpool |
$86.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$141.72
|
| Rate for Payer: Mclaren Commercial |
$80.69
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Mclaren Medicare |
$141.72
|
| Rate for Payer: Meridian Medicaid |
$81.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.21
|
| Rate for Payer: PACE Medicare |
$134.63
|
| Rate for Payer: PACE SWMI |
$141.72
|
| Rate for Payer: PHP Commercial |
$155.89
|
| Rate for Payer: PHP Medicaid |
$77.52
|
| Rate for Payer: PHP Medicare Advantage |
$141.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.59
|
| Rate for Payer: Priority Health Medicare |
$141.72
|
| Rate for Payer: Priority Health Narrow Network |
$63.66
|
| Rate for Payer: Railroad Medicare Medicare |
$141.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.90
|
| Rate for Payer: UHC Medicare Advantage |
$145.97
|
| Rate for Payer: VA VA |
$141.72
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
OP
|
$4,251.46
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,700.58 |
| Max. Negotiated Rate |
$4,251.46 |
| Rate for Payer: Aetna Commercial |
$3,826.31
|
| Rate for Payer: ASR ASR |
$4,123.92
|
| Rate for Payer: BCBS Complete |
$1,700.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.16
|
| Rate for Payer: BCN Commercial |
$3,296.16
|
| Rate for Payer: Cash Price |
$3,401.17
|
| Rate for Payer: Cofinity Commercial |
$3,996.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.17
|
| Rate for Payer: Healthscope Commercial |
$4,251.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,123.92
|
| Rate for Payer: Mclaren Commercial |
$3,826.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,613.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,976.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,868.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,018.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,741.28
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
IP
|
$4,251.46
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,976.02 |
| Max. Negotiated Rate |
$4,251.46 |
| Rate for Payer: Aetna Commercial |
$3,826.31
|
| Rate for Payer: ASR ASR |
$4,123.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.16
|
| Rate for Payer: BCN Commercial |
$3,296.16
|
| Rate for Payer: Cash Price |
$3,401.17
|
| Rate for Payer: Cofinity Commercial |
$3,996.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.17
|
| Rate for Payer: Healthscope Commercial |
$4,251.46
|
| Rate for Payer: Healthscope Whirlpool |
$4,123.92
|
| Rate for Payer: Mclaren Commercial |
$3,826.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,613.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,976.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,741.28
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
OP
|
$8,555.36
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,573.80 |
| Max. Negotiated Rate |
$8,555.36 |
| Rate for Payer: Aetna Commercial |
$7,699.82
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$8,298.70
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,632.97
|
| Rate for Payer: BCN Commercial |
$6,632.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$6,844.29
|
| Rate for Payer: Cash Price |
$6,844.29
|
| Rate for Payer: Cofinity Commercial |
$8,042.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,844.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$8,555.36
|
| Rate for Payer: Healthscope Whirlpool |
$8,298.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$7,699.82
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,272.06
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,988.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,785.38
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$6,074.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,528.72
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
IP
|
$8,555.36
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,988.75 |
| Max. Negotiated Rate |
$8,555.36 |
| Rate for Payer: Aetna Commercial |
$7,699.82
|
| Rate for Payer: ASR ASR |
$8,298.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,632.97
|
| Rate for Payer: BCN Commercial |
$6,632.97
|
| Rate for Payer: Cash Price |
$6,844.29
|
| Rate for Payer: Cofinity Commercial |
$8,042.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,844.29
|
| Rate for Payer: Healthscope Commercial |
$8,555.36
|
| Rate for Payer: Healthscope Whirlpool |
$8,298.70
|
| Rate for Payer: Mclaren Commercial |
$7,699.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,988.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,528.72
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
IP
|
$151.08
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$105.76 |
| Max. Negotiated Rate |
$151.08 |
| Rate for Payer: Aetna Commercial |
$135.97
|
| Rate for Payer: ASR ASR |
$146.55
|
| Rate for Payer: BCBS Trust/PPO |
$117.13
|
| Rate for Payer: BCN Commercial |
$117.13
|
| Rate for Payer: Cash Price |
$120.86
|
| Rate for Payer: Cofinity Commercial |
$142.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.86
|
| Rate for Payer: Healthscope Commercial |
$151.08
|
| Rate for Payer: Healthscope Whirlpool |
$146.55
|
| Rate for Payer: Mclaren Commercial |
$135.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.95
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
OP
|
$151.08
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$151.08 |
| Rate for Payer: Aetna Commercial |
$135.97
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.46
|
| Rate for Payer: ASR ASR |
$146.55
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$18.77
|
| Rate for Payer: BCBS Trust/PPO |
$117.13
|
| Rate for Payer: BCN Commercial |
$117.13
|
| Rate for Payer: BCN Medicare Advantage |
$18.77
|
| Rate for Payer: Cash Price |
$120.86
|
| Rate for Payer: Cash Price |
$120.86
|
| Rate for Payer: Cofinity Commercial |
$142.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$151.08
|
| Rate for Payer: Healthscope Whirlpool |
$146.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.77
|
| Rate for Payer: Mclaren Commercial |
$135.97
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Mclaren Medicare |
$18.77
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.42
|
| Rate for Payer: PACE Medicare |
$17.83
|
| Rate for Payer: PACE SWMI |
$18.77
|
| Rate for Payer: PHP Commercial |
$20.65
|
| Rate for Payer: PHP Medicaid |
$10.27
|
| Rate for Payer: PHP Medicare Advantage |
$18.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.48
|
| Rate for Payer: Priority Health Medicare |
$18.77
|
| Rate for Payer: Priority Health Narrow Network |
$107.27
|
| Rate for Payer: Railroad Medicare Medicare |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.95
|
| Rate for Payer: UHC Medicare Advantage |
$19.33
|
| Rate for Payer: VA VA |
$18.77
|
|
|
HC FDG PER DOSE
|
Facility
|
IP
|
$762.71
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$533.90 |
| Max. Negotiated Rate |
$762.71 |
| Rate for Payer: Aetna Commercial |
$686.44
|
| Rate for Payer: ASR ASR |
$739.83
|
| Rate for Payer: BCBS Trust/PPO |
$591.33
|
| Rate for Payer: BCN Commercial |
$591.33
|
| Rate for Payer: Cash Price |
$610.17
|
| Rate for Payer: Cofinity Commercial |
$716.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.17
|
| Rate for Payer: Healthscope Commercial |
$762.71
|
| Rate for Payer: Healthscope Whirlpool |
$739.83
|
| Rate for Payer: Mclaren Commercial |
$686.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$671.18
|
|
|
HC FDG PER DOSE
|
Facility
|
OP
|
$762.71
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$305.08 |
| Max. Negotiated Rate |
$762.71 |
| Rate for Payer: Aetna Commercial |
$686.44
|
| Rate for Payer: ASR ASR |
$739.83
|
| Rate for Payer: BCBS Complete |
$305.08
|
| Rate for Payer: BCBS Trust/PPO |
$591.33
|
| Rate for Payer: BCN Commercial |
$591.33
|
| Rate for Payer: Cash Price |
$610.17
|
| Rate for Payer: Cofinity Commercial |
$716.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.17
|
| Rate for Payer: Healthscope Commercial |
$762.71
|
| Rate for Payer: Healthscope Whirlpool |
$739.83
|
| Rate for Payer: Mclaren Commercial |
$686.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.07
|
| Rate for Payer: Priority Health Narrow Network |
$541.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$671.18
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
OP
|
$33.55
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$41.05 |
| Rate for Payer: Aetna Commercial |
$30.20
|
| Rate for Payer: Aetna Medicare |
$5.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: ASR ASR |
$32.54
|
| Rate for Payer: BCBS Complete |
$2.93
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$26.01
|
| Rate for Payer: BCN Commercial |
$26.01
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$26.84
|
| Rate for Payer: Cash Price |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$31.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$33.55
|
| Rate for Payer: Healthscope Whirlpool |
$32.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.10
|
| Rate for Payer: Mclaren Commercial |
$30.20
|
| Rate for Payer: Mclaren Medicaid |
$2.79
|
| Rate for Payer: Mclaren Medicare |
$5.10
|
| Rate for Payer: Meridian Medicaid |
$2.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.52
|
| Rate for Payer: PACE Medicare |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$5.61
|
| Rate for Payer: PHP Medicaid |
$2.79
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.05
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow Network |
$32.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.52
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
IP
|
$33.55
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$33.55 |
| Rate for Payer: Aetna Commercial |
$30.20
|
| Rate for Payer: ASR ASR |
$32.54
|
| Rate for Payer: BCBS Trust/PPO |
$26.01
|
| Rate for Payer: BCN Commercial |
$26.01
|
| Rate for Payer: Cash Price |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$31.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.84
|
| Rate for Payer: Healthscope Commercial |
$33.55
|
| Rate for Payer: Healthscope Whirlpool |
$32.54
|
| Rate for Payer: Mclaren Commercial |
$30.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.52
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: ASR ASR |
$67.90
|
| Rate for Payer: BCBS Trust/PPO |
$54.27
|
| Rate for Payer: BCN Commercial |
$54.27
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$65.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$67.90
|
| Rate for Payer: Mclaren Commercial |
$63.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.60
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: Aetna Medicare |
$16.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: ASR ASR |
$67.90
|
| Rate for Payer: BCBS Complete |
$9.65
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$54.27
|
| Rate for Payer: BCN Commercial |
$54.27
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$65.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$67.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.80
|
| Rate for Payer: Mclaren Commercial |
$63.00
|
| Rate for Payer: Mclaren Medicaid |
$9.19
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Medicaid |
$9.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$18.48
|
| Rate for Payer: PHP Medicaid |
$9.19
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.70
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health Narrow Network |
$49.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.60
|
| Rate for Payer: UHC Medicare Advantage |
$17.30
|
| Rate for Payer: VA VA |
$16.80
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$52.80 |
| Rate for Payer: Aetna Commercial |
$47.52
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$51.22
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$40.94
|
| Rate for Payer: BCN Commercial |
$40.94
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$49.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$52.80
|
| Rate for Payer: Healthscope Whirlpool |
$51.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$47.52
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.78
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$24.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.46
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.96 |
| Max. Negotiated Rate |
$52.80 |
| Rate for Payer: Aetna Commercial |
$47.52
|
| Rate for Payer: ASR ASR |
$51.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.94
|
| Rate for Payer: BCN Commercial |
$40.94
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$49.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$52.80
|
| Rate for Payer: Healthscope Whirlpool |
$51.22
|
| Rate for Payer: Mclaren Commercial |
$47.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.46
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
IP
|
$1,281.69
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$897.18 |
| Max. Negotiated Rate |
$1,281.69 |
| Rate for Payer: Aetna Commercial |
$1,153.52
|
| Rate for Payer: ASR ASR |
$1,243.24
|
| Rate for Payer: BCBS Trust/PPO |
$993.69
|
| Rate for Payer: BCN Commercial |
$993.69
|
| Rate for Payer: Cash Price |
$1,025.35
|
| Rate for Payer: Cofinity Commercial |
$1,204.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.35
|
| Rate for Payer: Healthscope Commercial |
$1,281.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,243.24
|
| Rate for Payer: Mclaren Commercial |
$1,153.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,089.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,127.89
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
OP
|
$1,281.69
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$1,281.69 |
| Rate for Payer: Aetna Commercial |
$1,153.52
|
| Rate for Payer: Aetna Medicare |
$805.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: ASR ASR |
$1,243.24
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$993.69
|
| Rate for Payer: BCN Commercial |
$993.69
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$1,025.35
|
| Rate for Payer: Cash Price |
$1,025.35
|
| Rate for Payer: Cofinity Commercial |
$1,204.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$1,281.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,243.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$805.75
|
| Rate for Payer: Mclaren Commercial |
$1,153.52
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,089.44
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$886.32
|
| Rate for Payer: PHP Medicaid |
$440.75
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,166.34
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$910.00
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,127.89
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: VA VA |
$805.75
|
|
|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$15.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: BCBS Complete |
$9.14
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.92
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Mclaren Medicare |
$15.92
|
| Rate for Payer: Meridian Medicaid |
$9.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Medicare |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$17.51
|
| Rate for Payer: PHP Medicaid |
$8.71
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.85
|
| Rate for Payer: Priority Health Medicare |
$15.92
|
| Rate for Payer: Priority Health Narrow Network |
$21.73
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
| Rate for Payer: UHC Medicare Advantage |
$16.40
|
| Rate for Payer: VA VA |
$15.92
|
|
|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$48.74 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.48
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: BCBS Complete |
$2.52
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.38
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Mclaren Medicaid |
$2.40
|
| Rate for Payer: Mclaren Medicare |
$4.38
|
| Rate for Payer: Meridian Medicaid |
$2.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Medicare |
$4.16
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Commercial |
$4.82
|
| Rate for Payer: PHP Medicaid |
$2.40
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.74
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Narrow Network |
$38.99
|
| Rate for Payer: Railroad Medicare Medicare |
$4.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
| Rate for Payer: UHC Medicare Advantage |
$4.51
|
| Rate for Payer: VA VA |
$4.38
|
|
|
HC FECAL PH
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$23.46 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: ASR ASR |
$22.76
|
| Rate for Payer: BCBS Trust/PPO |
$18.19
|
| Rate for Payer: BCN Commercial |
$18.19
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$23.46
|
| Rate for Payer: Healthscope Whirlpool |
$22.76
|
| Rate for Payer: Mclaren Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.64
|
|
|
HC FECAL PH
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$23.46 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.48
|
| Rate for Payer: ASR ASR |
$22.76
|
| Rate for Payer: BCBS Complete |
$2.06
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$18.19
|
| Rate for Payer: BCN Commercial |
$18.19
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$23.46
|
| Rate for Payer: Healthscope Whirlpool |
$22.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.58
|
| Rate for Payer: Mclaren Commercial |
$21.11
|
| Rate for Payer: Mclaren Medicaid |
$1.96
|
| Rate for Payer: Mclaren Medicare |
$3.58
|
| Rate for Payer: Meridian Medicaid |
$2.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PACE Medicare |
$3.40
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: PHP Medicaid |
$1.96
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: Priority Health Narrow Network |
$10.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.64
|
| Rate for Payer: UHC Medicare Advantage |
$3.69
|
| Rate for Payer: VA VA |
$3.58
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
IP
|
$50.30
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.21 |
| Max. Negotiated Rate |
$50.30 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: ASR ASR |
$48.79
|
| Rate for Payer: BCBS Trust/PPO |
$39.00
|
| Rate for Payer: BCN Commercial |
$39.00
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$47.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Healthscope Commercial |
$50.30
|
| Rate for Payer: Healthscope Whirlpool |
$48.79
|
| Rate for Payer: Mclaren Commercial |
$45.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.26
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
OP
|
$50.30
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$50.30 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.88
|
| Rate for Payer: ASR ASR |
$48.79
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS MAPPO |
$5.50
|
| Rate for Payer: BCBS Trust/PPO |
$39.00
|
| Rate for Payer: BCN Commercial |
$39.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.50
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$47.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.50
|
| Rate for Payer: Healthscope Commercial |
$50.30
|
| Rate for Payer: Healthscope Whirlpool |
$48.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.50
|
| Rate for Payer: Mclaren Commercial |
$45.27
|
| Rate for Payer: Mclaren Medicaid |
$3.01
|
| Rate for Payer: Mclaren Medicare |
$5.50
|
| Rate for Payer: Meridian Medicaid |
$3.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PACE Medicare |
$5.22
|
| Rate for Payer: PACE SWMI |
$5.50
|
| Rate for Payer: PHP Commercial |
$6.05
|
| Rate for Payer: PHP Medicaid |
$3.01
|
| Rate for Payer: PHP Medicare Advantage |
$5.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.40
|
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Railroad Medicare Medicare |
$5.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.26
|
| Rate for Payer: UHC Medicare Advantage |
$5.66
|
| Rate for Payer: VA VA |
$5.50
|
|
