|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
OP
|
$18.73
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$16.86
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$18.17
|
| Rate for Payer: ASR Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$15.34
|
| Rate for Payer: BCN Commercial |
$14.52
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Healthscope Whirlpool |
$18.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$16.86
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$15.36
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.41
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$13.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
IP
|
$18.73
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$16.86
|
| Rate for Payer: ASR ASR |
$18.17
|
| Rate for Payer: ASR Commercial |
$18.17
|
| Rate for Payer: BCBS Trust/PPO |
$15.26
|
| Rate for Payer: BCN Commercial |
$14.52
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Healthscope Whirlpool |
$18.17
|
| Rate for Payer: Mclaren Commercial |
$16.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.48
|
|
|
HC C DIFFICILE PCR
|
Facility
|
OP
|
$140.66
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.98 |
| Max. Negotiated Rate |
$140.66 |
| Rate for Payer: Aetna Commercial |
$126.59
|
| Rate for Payer: Aetna Medicare |
$37.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.59
|
| Rate for Payer: ASR ASR |
$136.44
|
| Rate for Payer: ASR Commercial |
$136.44
|
| Rate for Payer: BCBS Complete |
$20.98
|
| Rate for Payer: BCBS MAPPO |
$37.27
|
| Rate for Payer: BCBS Trust/PPO |
$115.19
|
| Rate for Payer: BCN Commercial |
$109.05
|
| Rate for Payer: BCN Medicare Advantage |
$37.27
|
| Rate for Payer: Cash Price |
$112.53
|
| Rate for Payer: Cash Price |
$112.53
|
| Rate for Payer: Cofinity Commercial |
$132.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.27
|
| Rate for Payer: Healthscope Commercial |
$140.66
|
| Rate for Payer: Healthscope Whirlpool |
$136.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.27
|
| Rate for Payer: Mclaren Commercial |
$126.59
|
| Rate for Payer: Mclaren Medicaid |
$19.98
|
| Rate for Payer: Mclaren Medicare |
$37.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.13
|
| Rate for Payer: Meridian Medicaid |
$20.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.56
|
| Rate for Payer: Nomi Health Commercial |
$115.34
|
| Rate for Payer: PACE Medicare |
$35.41
|
| Rate for Payer: PACE SWMI |
$37.27
|
| Rate for Payer: PHP Commercial |
$41.00
|
| Rate for Payer: PHP Medicaid |
$19.98
|
| Rate for Payer: PHP Medicare Advantage |
$37.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.25
|
| Rate for Payer: Priority Health Medicare |
$37.27
|
| Rate for Payer: Priority Health Narrow Network |
$98.60
|
| Rate for Payer: Railroad Medicare Medicare |
$37.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.27
|
| Rate for Payer: UHC Exchange |
$57.77
|
| Rate for Payer: UHC Medicare Advantage |
$37.27
|
| Rate for Payer: UHCCP DNSP |
$37.27
|
| Rate for Payer: UHCCP Medicaid |
$19.98
|
| Rate for Payer: VA VA |
$37.27
|
|
|
HC C DIFFICILE PCR
|
Facility
|
IP
|
$140.66
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$91.43 |
| Max. Negotiated Rate |
$140.66 |
| Rate for Payer: Aetna Commercial |
$126.59
|
| Rate for Payer: ASR ASR |
$136.44
|
| Rate for Payer: ASR Commercial |
$136.44
|
| Rate for Payer: BCBS Trust/PPO |
$114.62
|
| Rate for Payer: BCN Commercial |
$109.05
|
| Rate for Payer: Cash Price |
$112.53
|
| Rate for Payer: Cofinity Commercial |
$132.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.53
|
| Rate for Payer: Healthscope Commercial |
$140.66
|
| Rate for Payer: Healthscope Whirlpool |
$136.44
|
| Rate for Payer: Mclaren Commercial |
$126.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.56
|
| Rate for Payer: Nomi Health Commercial |
$115.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.78
|
|
|
HC C DIFF TOXIN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC C DIFF TOXIN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.47
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$130.76
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.16 |
| Max. Negotiated Rate |
$130.76 |
| Rate for Payer: Aetna Commercial |
$117.68
|
| Rate for Payer: Aetna Medicare |
$18.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: ASR ASR |
$126.84
|
| Rate for Payer: ASR Commercial |
$126.84
|
| Rate for Payer: BCBS Complete |
$10.67
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$107.08
|
| Rate for Payer: BCN Commercial |
$101.38
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cofinity Commercial |
$122.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$130.76
|
| Rate for Payer: Healthscope Whirlpool |
$126.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.96
|
| Rate for Payer: Mclaren Commercial |
$117.68
|
| Rate for Payer: Mclaren Medicaid |
$10.16
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: Meridian Medicaid |
$10.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.15
|
| Rate for Payer: Nomi Health Commercial |
$107.22
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$20.86
|
| Rate for Payer: PHP Medicaid |
$10.16
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.57
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health Narrow Network |
$91.66
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.96
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicare Advantage |
$18.96
|
| Rate for Payer: UHCCP DNSP |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$10.16
|
| Rate for Payer: VA VA |
$18.96
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$130.76
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$130.76 |
| Rate for Payer: Aetna Commercial |
$117.68
|
| Rate for Payer: ASR ASR |
$126.84
|
| Rate for Payer: ASR Commercial |
$126.84
|
| Rate for Payer: BCBS Trust/PPO |
$106.56
|
| Rate for Payer: BCN Commercial |
$101.38
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cofinity Commercial |
$122.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.61
|
| Rate for Payer: Healthscope Commercial |
$130.76
|
| Rate for Payer: Healthscope Whirlpool |
$126.84
|
| Rate for Payer: Mclaren Commercial |
$117.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.15
|
| Rate for Payer: Nomi Health Commercial |
$107.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.07
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$184.37
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.16 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna Commercial |
$165.93
|
| Rate for Payer: Aetna Medicare |
$18.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: ASR ASR |
$178.84
|
| Rate for Payer: ASR Commercial |
$178.84
|
| Rate for Payer: BCBS Complete |
$10.67
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$150.98
|
| Rate for Payer: BCN Commercial |
$142.94
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cofinity Commercial |
$173.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Healthscope Whirlpool |
$178.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.96
|
| Rate for Payer: Mclaren Commercial |
$165.93
|
| Rate for Payer: Mclaren Medicaid |
$10.16
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: Meridian Medicaid |
$10.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.71
|
| Rate for Payer: Nomi Health Commercial |
$151.18
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$20.86
|
| Rate for Payer: PHP Medicaid |
$10.16
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.54
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health Narrow Network |
$129.24
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.96
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicare Advantage |
$18.96
|
| Rate for Payer: UHCCP DNSP |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$10.16
|
| Rate for Payer: VA VA |
$18.96
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$184.37
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.84 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna Commercial |
$165.93
|
| Rate for Payer: ASR ASR |
$178.84
|
| Rate for Payer: ASR Commercial |
$178.84
|
| Rate for Payer: BCBS Trust/PPO |
$150.24
|
| Rate for Payer: BCN Commercial |
$142.94
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cofinity Commercial |
$173.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.50
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Healthscope Whirlpool |
$178.84
|
| Rate for Payer: Mclaren Commercial |
$165.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.71
|
| Rate for Payer: Nomi Health Commercial |
$151.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.25
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$190.74
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$190.74 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: ASR ASR |
$185.02
|
| Rate for Payer: ASR Commercial |
$185.02
|
| Rate for Payer: BCBS Complete |
$14.53
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$156.20
|
| Rate for Payer: BCN Commercial |
$147.88
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$179.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$190.74
|
| Rate for Payer: Healthscope Whirlpool |
$185.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.81
|
| Rate for Payer: Mclaren Commercial |
$171.67
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.13
|
| Rate for Payer: Nomi Health Commercial |
$156.41
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$28.39
|
| Rate for Payer: PHP Medicaid |
$13.83
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.13
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$133.71
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.81
|
| Rate for Payer: UHC Exchange |
$40.01
|
| Rate for Payer: UHC Medicare Advantage |
$25.81
|
| Rate for Payer: UHCCP DNSP |
$25.81
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: VA VA |
$25.81
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$199.93 |
| Rate for Payer: Aetna Commercial |
$179.94
|
| Rate for Payer: ASR ASR |
$193.93
|
| Rate for Payer: ASR Commercial |
$193.93
|
| Rate for Payer: BCBS Trust/PPO |
$162.92
|
| Rate for Payer: BCN Commercial |
$155.01
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$187.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Healthscope Commercial |
$199.93
|
| Rate for Payer: Healthscope Whirlpool |
$193.93
|
| Rate for Payer: Mclaren Commercial |
$179.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.94
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$190.74
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$123.98 |
| Max. Negotiated Rate |
$190.74 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: ASR ASR |
$185.02
|
| Rate for Payer: ASR Commercial |
$185.02
|
| Rate for Payer: BCBS Trust/PPO |
$155.43
|
| Rate for Payer: BCN Commercial |
$147.88
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$179.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$190.74
|
| Rate for Payer: Healthscope Whirlpool |
$185.02
|
| Rate for Payer: Mclaren Commercial |
$171.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.13
|
| Rate for Payer: Nomi Health Commercial |
$156.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.85
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.51 |
| Max. Negotiated Rate |
$199.93 |
| Rate for Payer: Aetna Commercial |
$179.94
|
| Rate for Payer: Aetna Medicare |
$122.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: ASR ASR |
$193.93
|
| Rate for Payer: ASR Commercial |
$193.93
|
| Rate for Payer: BCBS Complete |
$68.79
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$163.72
|
| Rate for Payer: BCN Commercial |
$155.01
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$187.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$199.93
|
| Rate for Payer: Healthscope Whirlpool |
$193.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$122.22
|
| Rate for Payer: Mclaren Commercial |
$179.94
|
| Rate for Payer: Mclaren Medicaid |
$65.51
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: Meridian Medicaid |
$68.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$134.44
|
| Rate for Payer: PHP Medicaid |
$65.51
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.18
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow Network |
$140.15
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
| Rate for Payer: UHC Exchange |
$189.44
|
| Rate for Payer: UHC Medicare Advantage |
$122.22
|
| Rate for Payer: UHCCP DNSP |
$122.22
|
| Rate for Payer: UHCCP Medicaid |
$65.51
|
| Rate for Payer: VA VA |
$122.22
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.51 |
| Max. Negotiated Rate |
$199.93 |
| Rate for Payer: Aetna Commercial |
$179.94
|
| Rate for Payer: Aetna Medicare |
$122.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: ASR ASR |
$193.93
|
| Rate for Payer: ASR Commercial |
$193.93
|
| Rate for Payer: BCBS Complete |
$68.79
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$163.72
|
| Rate for Payer: BCN Commercial |
$155.01
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$187.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$199.93
|
| Rate for Payer: Healthscope Whirlpool |
$193.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$122.22
|
| Rate for Payer: Mclaren Commercial |
$179.94
|
| Rate for Payer: Mclaren Medicaid |
$65.51
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: Meridian Medicaid |
$68.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$134.44
|
| Rate for Payer: PHP Medicaid |
$65.51
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.18
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow Network |
$140.15
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
| Rate for Payer: UHC Exchange |
$189.44
|
| Rate for Payer: UHC Medicare Advantage |
$122.22
|
| Rate for Payer: UHCCP DNSP |
$122.22
|
| Rate for Payer: UHCCP Medicaid |
$65.51
|
| Rate for Payer: VA VA |
$122.22
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$199.93 |
| Rate for Payer: Aetna Commercial |
$179.94
|
| Rate for Payer: ASR ASR |
$193.93
|
| Rate for Payer: ASR Commercial |
$193.93
|
| Rate for Payer: BCBS Trust/PPO |
$162.92
|
| Rate for Payer: BCN Commercial |
$155.01
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$187.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Healthscope Commercial |
$199.93
|
| Rate for Payer: Healthscope Whirlpool |
$193.93
|
| Rate for Payer: Mclaren Commercial |
$179.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.94
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$28.41 |
| Rate for Payer: Aetna Commercial |
$25.57
|
| Rate for Payer: ASR ASR |
$27.56
|
| Rate for Payer: ASR Commercial |
$27.56
|
| Rate for Payer: BCBS Trust/PPO |
$23.15
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$28.41
|
| Rate for Payer: Healthscope Whirlpool |
$27.56
|
| Rate for Payer: Mclaren Commercial |
$25.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.00
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$28.41 |
| Rate for Payer: Aetna Commercial |
$25.57
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$27.56
|
| Rate for Payer: ASR Commercial |
$27.56
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$28.41
|
| Rate for Payer: Healthscope Whirlpool |
$27.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$25.57
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.89
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$19.92
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$28.41 |
| Rate for Payer: Aetna Commercial |
$25.57
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$27.56
|
| Rate for Payer: ASR Commercial |
$27.56
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$28.41
|
| Rate for Payer: Healthscope Whirlpool |
$27.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$25.57
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.89
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$19.92
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$28.41 |
| Rate for Payer: Aetna Commercial |
$25.57
|
| Rate for Payer: ASR ASR |
$27.56
|
| Rate for Payer: ASR Commercial |
$27.56
|
| Rate for Payer: BCBS Trust/PPO |
$23.15
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$28.41
|
| Rate for Payer: Healthscope Whirlpool |
$27.56
|
| Rate for Payer: Mclaren Commercial |
$25.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.00
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,211.27
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,345.83 |
| Rate for Payer: Aetna Commercial |
$1,090.14
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,174.93
|
| Rate for Payer: ASR Commercial |
$1,174.93
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$991.91
|
| Rate for Payer: BCN Commercial |
$939.10
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cofinity Commercial |
$1,138.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,174.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,090.14
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.58
|
| Rate for Payer: Nomi Health Commercial |
$993.24
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,061.31
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$849.10
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,065.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,211.27
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$787.33 |
| Max. Negotiated Rate |
$1,211.27 |
| Rate for Payer: Aetna Commercial |
$1,090.14
|
| Rate for Payer: ASR ASR |
$1,174.93
|
| Rate for Payer: ASR Commercial |
$1,174.93
|
| Rate for Payer: BCBS Trust/PPO |
$987.06
|
| Rate for Payer: BCN Commercial |
$939.10
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cofinity Commercial |
$1,138.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.02
|
| Rate for Payer: Healthscope Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,174.93
|
| Rate for Payer: Mclaren Commercial |
$1,090.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.58
|
| Rate for Payer: Nomi Health Commercial |
$993.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,065.92
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$111.38 |
| Max. Negotiated Rate |
$171.36 |
| Rate for Payer: Aetna Commercial |
$154.22
|
| Rate for Payer: ASR ASR |
$166.22
|
| Rate for Payer: ASR Commercial |
$166.22
|
| Rate for Payer: BCBS Trust/PPO |
$139.64
|
| Rate for Payer: BCN Commercial |
$132.86
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$161.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Healthscope Commercial |
$171.36
|
| Rate for Payer: Healthscope Whirlpool |
$166.22
|
| Rate for Payer: Mclaren Commercial |
$154.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.66
|
| Rate for Payer: Nomi Health Commercial |
$140.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.80
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.68 |
| Max. Negotiated Rate |
$171.36 |
| Rate for Payer: Aetna Commercial |
$154.22
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.57
|
| Rate for Payer: ASR ASR |
$166.22
|
| Rate for Payer: ASR Commercial |
$166.22
|
| Rate for Payer: BCBS Complete |
$7.01
|
| Rate for Payer: BCBS MAPPO |
$12.46
|
| Rate for Payer: BCBS Trust/PPO |
$140.33
|
| Rate for Payer: BCN Commercial |
$132.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.46
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$161.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.46
|
| Rate for Payer: Healthscope Commercial |
$171.36
|
| Rate for Payer: Healthscope Whirlpool |
$166.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.46
|
| Rate for Payer: Mclaren Commercial |
$154.22
|
| Rate for Payer: Mclaren Medicaid |
$6.68
|
| Rate for Payer: Mclaren Medicare |
$12.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.08
|
| Rate for Payer: Meridian Medicaid |
$7.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.66
|
| Rate for Payer: Nomi Health Commercial |
$140.52
|
| Rate for Payer: PACE Medicare |
$11.84
|
| Rate for Payer: PACE SWMI |
$12.46
|
| Rate for Payer: PHP Commercial |
$13.71
|
| Rate for Payer: PHP Medicaid |
$6.68
|
| Rate for Payer: PHP Medicare Advantage |
$12.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.15
|
| Rate for Payer: Priority Health Medicare |
$12.46
|
| Rate for Payer: Priority Health Narrow Network |
$120.12
|
| Rate for Payer: Railroad Medicare Medicare |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.46
|
| Rate for Payer: UHC Exchange |
$19.31
|
| Rate for Payer: UHC Medicare Advantage |
$12.46
|
| Rate for Payer: UHCCP DNSP |
$12.46
|
| Rate for Payer: UHCCP Medicaid |
$6.68
|
| Rate for Payer: VA VA |
$12.46
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$92.21
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$92.21 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Medicare |
$5.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.00
|
| Rate for Payer: ASR ASR |
$89.44
|
| Rate for Payer: ASR Commercial |
$89.44
|
| Rate for Payer: BCBS Complete |
$3.15
|
| Rate for Payer: BCBS MAPPO |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$75.51
|
| Rate for Payer: BCN Commercial |
$71.49
|
| Rate for Payer: BCN Medicare Advantage |
$5.60
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$86.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.60
|
| Rate for Payer: Healthscope Commercial |
$92.21
|
| Rate for Payer: Healthscope Whirlpool |
$89.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.60
|
| Rate for Payer: Mclaren Commercial |
$82.99
|
| Rate for Payer: Mclaren Medicaid |
$3.00
|
| Rate for Payer: Mclaren Medicare |
$5.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.88
|
| Rate for Payer: Meridian Medicaid |
$3.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PACE Medicare |
$5.32
|
| Rate for Payer: PACE SWMI |
$5.60
|
| Rate for Payer: PHP Commercial |
$6.16
|
| Rate for Payer: PHP Medicaid |
$3.00
|
| Rate for Payer: PHP Medicare Advantage |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.79
|
| Rate for Payer: Priority Health Medicare |
$5.60
|
| Rate for Payer: Priority Health Narrow Network |
$64.64
|
| Rate for Payer: Railroad Medicare Medicare |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.60
|
| Rate for Payer: UHC Exchange |
$8.68
|
| Rate for Payer: UHC Medicare Advantage |
$5.60
|
| Rate for Payer: UHCCP DNSP |
$5.60
|
| Rate for Payer: UHCCP Medicaid |
$3.00
|
| Rate for Payer: VA VA |
$5.60
|
|
