|
HC CORTICAL MAPPING
|
Facility
|
OP
|
$2,193.52
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$2,193.52 |
| Rate for Payer: Aetna Commercial |
$1,974.17
|
| Rate for Payer: Aetna Medicare |
$855.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: ASR ASR |
$2,127.71
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.56
|
| Rate for Payer: BCN Commercial |
$1,808.56
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$1,754.82
|
| Rate for Payer: Cash Price |
$1,754.82
|
| Rate for Payer: Cofinity Commercial |
$2,061.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,754.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$2,127.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,193.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$855.65
|
| Rate for Payer: Mclaren Commercial |
$1,974.17
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$469.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.49
|
| Rate for Payer: Nomi Health Commercial |
$1,798.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,645.14
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$941.22
|
| Rate for Payer: PHP Medicaid |
$458.63
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,921.96
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,537.66
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,930.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,326.26
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP DNSP |
$855.65
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: VA VA |
$855.65
|
|
|
HC CORTICAL MAPPING
|
Facility
|
IP
|
$2,193.52
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,645.14 |
| Max. Negotiated Rate |
$2,193.52 |
| Rate for Payer: Aetna Commercial |
$1,974.17
|
| Rate for Payer: ASR ASR |
$2,127.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.32
|
| Rate for Payer: BCN Commercial |
$1,801.32
|
| Rate for Payer: Cash Price |
$1,754.82
|
| Rate for Payer: Cofinity Commercial |
$2,061.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,754.82
|
| Rate for Payer: Healthscope Commercial |
$2,127.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,193.52
|
| Rate for Payer: Mclaren Commercial |
$1,974.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.49
|
| Rate for Payer: Nomi Health Commercial |
$1,798.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,645.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,930.30
|
|
|
HC CORTICOL SALIVA
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$68.98 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Trust/PPO |
$56.65
|
| Rate for Payer: BCN Commercial |
$56.65
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
|
|
HC CORTICOL SALIVA
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$68.98 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: Aetna Medicare |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$56.87
|
| Rate for Payer: BCN Commercial |
$56.87
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.30
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$16.30
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.11
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$17.93
|
| Rate for Payer: PHP Medicaid |
$8.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$44.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.30
|
| Rate for Payer: UHC Exchange |
$25.27
|
| Rate for Payer: UHC Medicaid |
$8.52
|
| Rate for Payer: UHCCP DNSP |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.54
|
| Rate for Payer: BCN Commercial |
$55.54
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$65.60
|
| Rate for Payer: Healthscope Whirlpool |
$67.63
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: Aetna Medicare |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$55.76
|
| Rate for Payer: BCN Commercial |
$55.76
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$65.60
|
| Rate for Payer: Healthscope Whirlpool |
$67.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.30
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$16.30
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.11
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$17.93
|
| Rate for Payer: PHP Medicaid |
$8.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$44.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.30
|
| Rate for Payer: UHC Exchange |
$25.27
|
| Rate for Payer: UHC Medicaid |
$8.52
|
| Rate for Payer: UHCCP DNSP |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL SERUM
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$68.98 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Trust/PPO |
$56.65
|
| Rate for Payer: BCN Commercial |
$56.65
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
|
|
HC CORTISOL SERUM
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$68.98 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: Aetna Medicare |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$56.87
|
| Rate for Payer: BCN Commercial |
$56.87
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.30
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$16.30
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.11
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$17.93
|
| Rate for Payer: PHP Medicaid |
$8.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$44.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.30
|
| Rate for Payer: UHC Exchange |
$25.27
|
| Rate for Payer: UHC Medicaid |
$8.52
|
| Rate for Payer: UHCCP DNSP |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTISOL URINE
|
Facility
|
OP
|
$48.82
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$48.82 |
| Rate for Payer: Aetna Commercial |
$43.94
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: ASR ASR |
$47.36
|
| Rate for Payer: BCBS Complete |
$9.18
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$40.25
|
| Rate for Payer: BCN Commercial |
$40.25
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$45.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$47.36
|
| Rate for Payer: Healthscope Whirlpool |
$48.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.71
|
| Rate for Payer: Mclaren Commercial |
$43.94
|
| Rate for Payer: Mclaren Medicaid |
$16.71
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Nomi Health Commercial |
$40.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: PHP Medicaid |
$8.96
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.78
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health Narrow Network |
$34.22
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.71
|
| Rate for Payer: UHC Exchange |
$25.90
|
| Rate for Payer: UHC Medicaid |
$8.74
|
| Rate for Payer: UHCCP DNSP |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$8.74
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE
|
Facility
|
IP
|
$48.82
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.62 |
| Max. Negotiated Rate |
$48.82 |
| Rate for Payer: Aetna Commercial |
$43.94
|
| Rate for Payer: ASR ASR |
$47.36
|
| Rate for Payer: BCBS Trust/PPO |
$40.09
|
| Rate for Payer: BCN Commercial |
$40.09
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$45.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$47.36
|
| Rate for Payer: Healthscope Whirlpool |
$48.82
|
| Rate for Payer: Mclaren Commercial |
$43.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Nomi Health Commercial |
$40.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.96
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
OP
|
$76.39
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$76.39 |
| Rate for Payer: Aetna Commercial |
$68.75
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: ASR ASR |
$74.10
|
| Rate for Payer: BCBS Complete |
$9.18
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$62.98
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cofinity Commercial |
$71.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$74.10
|
| Rate for Payer: Healthscope Whirlpool |
$76.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.71
|
| Rate for Payer: Mclaren Commercial |
$68.75
|
| Rate for Payer: Mclaren Medicaid |
$16.71
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.93
|
| Rate for Payer: Nomi Health Commercial |
$62.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.29
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: PHP Medicaid |
$8.96
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.93
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health Narrow Network |
$53.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.71
|
| Rate for Payer: UHC Exchange |
$25.90
|
| Rate for Payer: UHC Medicaid |
$8.74
|
| Rate for Payer: UHCCP DNSP |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$8.74
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
IP
|
$76.39
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.29 |
| Max. Negotiated Rate |
$76.39 |
| Rate for Payer: Aetna Commercial |
$68.75
|
| Rate for Payer: ASR ASR |
$74.10
|
| Rate for Payer: BCBS Trust/PPO |
$62.73
|
| Rate for Payer: BCN Commercial |
$62.73
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cofinity Commercial |
$71.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.11
|
| Rate for Payer: Healthscope Commercial |
$74.10
|
| Rate for Payer: Healthscope Whirlpool |
$76.39
|
| Rate for Payer: Mclaren Commercial |
$68.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.93
|
| Rate for Payer: Nomi Health Commercial |
$62.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.22
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
OP
|
$28.02
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$37.34 |
| Rate for Payer: Aetna Commercial |
$25.22
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: ASR ASR |
$27.18
|
| Rate for Payer: BCBS Complete |
$13.23
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$23.10
|
| Rate for Payer: BCN Commercial |
$23.10
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$22.42
|
| Rate for Payer: Cash Price |
$22.42
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$27.18
|
| Rate for Payer: Healthscope Whirlpool |
$28.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$25.22
|
| Rate for Payer: Mclaren Medicaid |
$24.09
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.82
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.02
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$26.50
|
| Rate for Payer: PHP Medicaid |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24.55
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$19.64
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.09
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Medicaid |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.60
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
IP
|
$28.02
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$28.02 |
| Rate for Payer: Aetna Commercial |
$25.22
|
| Rate for Payer: ASR ASR |
$27.18
|
| Rate for Payer: BCBS Trust/PPO |
$23.01
|
| Rate for Payer: BCN Commercial |
$23.01
|
| Rate for Payer: Cash Price |
$22.42
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.42
|
| Rate for Payer: Healthscope Commercial |
$27.18
|
| Rate for Payer: Healthscope Whirlpool |
$28.02
|
| Rate for Payer: Mclaren Commercial |
$25.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.82
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.66
|
|
|
HC COTTONWOOD IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC COTTONWOOD IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
OP
|
$223.69
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$223.69 |
| Rate for Payer: Aetna Commercial |
$201.32
|
| Rate for Payer: Aetna Medicare |
$101.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: ASR ASR |
$216.98
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$184.43
|
| Rate for Payer: BCN Commercial |
$184.43
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$178.95
|
| Rate for Payer: Cash Price |
$178.95
|
| Rate for Payer: Cofinity Commercial |
$210.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$216.98
|
| Rate for Payer: Healthscope Whirlpool |
$223.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$101.22
|
| Rate for Payer: Mclaren Commercial |
$201.32
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$55.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.14
|
| Rate for Payer: Nomi Health Commercial |
$183.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.77
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$111.34
|
| Rate for Payer: PHP Medicaid |
$54.25
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$196.00
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health Narrow Network |
$156.81
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$156.89
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP DNSP |
$101.22
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: VA VA |
$101.22
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
IP
|
$223.69
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$167.77 |
| Max. Negotiated Rate |
$223.69 |
| Rate for Payer: Aetna Commercial |
$201.32
|
| Rate for Payer: ASR ASR |
$216.98
|
| Rate for Payer: BCBS Trust/PPO |
$183.69
|
| Rate for Payer: BCN Commercial |
$183.69
|
| Rate for Payer: Cash Price |
$178.95
|
| Rate for Payer: Cofinity Commercial |
$210.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.95
|
| Rate for Payer: Healthscope Commercial |
$216.98
|
| Rate for Payer: Healthscope Whirlpool |
$223.69
|
| Rate for Payer: Mclaren Commercial |
$201.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.14
|
| Rate for Payer: Nomi Health Commercial |
$183.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.85
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.87 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$28.87
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Complete |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$64.34
|
| Rate for Payer: BCN Commercial |
$64.34
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.52 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$64.08
|
| Rate for Payer: BCN Commercial |
$64.08
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
IP
|
$6,655.44
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,991.58 |
| Max. Negotiated Rate |
$6,655.44 |
| Rate for Payer: Aetna Commercial |
$5,989.90
|
| Rate for Payer: ASR ASR |
$6,455.78
|
| Rate for Payer: BCBS Trust/PPO |
$5,465.45
|
| Rate for Payer: BCN Commercial |
$5,465.45
|
| Rate for Payer: Cash Price |
$5,324.35
|
| Rate for Payer: Cofinity Commercial |
$6,256.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.35
|
| Rate for Payer: Healthscope Commercial |
$6,455.78
|
| Rate for Payer: Healthscope Whirlpool |
$6,655.44
|
| Rate for Payer: Mclaren Commercial |
$5,989.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.12
|
| Rate for Payer: Nomi Health Commercial |
$5,457.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,991.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,856.79
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,655.44
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,462.51 |
| Max. Negotiated Rate |
$6,655.44 |
| Rate for Payer: Aetna Commercial |
$5,989.90
|
| Rate for Payer: Aetna Medicare |
$2,462.51
|
| Rate for Payer: ASR ASR |
$6,455.78
|
| Rate for Payer: BCBS Complete |
$2,662.18
|
| Rate for Payer: BCBS Trust/PPO |
$5,487.41
|
| Rate for Payer: BCN Commercial |
$5,487.41
|
| Rate for Payer: Cash Price |
$5,324.35
|
| Rate for Payer: Cofinity Commercial |
$6,256.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.35
|
| Rate for Payer: Healthscope Commercial |
$6,455.78
|
| Rate for Payer: Healthscope Whirlpool |
$6,655.44
|
| Rate for Payer: Mclaren Commercial |
$5,989.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,324.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.12
|
| Rate for Payer: Nomi Health Commercial |
$5,457.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,991.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,831.50
|
| Rate for Payer: Priority Health Narrow Network |
$4,665.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,856.79
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.13 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Trust/PPO |
$59.27
|
| Rate for Payer: BCN Commercial |
$59.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.03 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Complete |
$23.14
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCBS Trust/PPO |
$59.50
|
| Rate for Payer: BCN Commercial |
$59.50
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.13
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Mclaren Medicaid |
$42.13
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$23.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$46.34
|
| Rate for Payer: PHP Medicaid |
$22.58
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53.18
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health Narrow Network |
$42.55
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.13
|
| Rate for Payer: UHC Exchange |
$65.30
|
| Rate for Payer: UHC Medicaid |
$22.03
|
| Rate for Payer: UHCCP DNSP |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$22.03
|
| Rate for Payer: VA VA |
$42.13
|
|
|
HC COVID 19 PCR
|
Facility
|
OP
|
$127.35
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$127.35 |
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$123.53
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$105.00
|
| Rate for Payer: BCN Commercial |
$105.00
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Commercial |
$119.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$123.53
|
| Rate for Payer: Healthscope Whirlpool |
$127.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$114.61
|
| Rate for Payer: Mclaren Medicaid |
$51.31
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$104.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.76
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$51.81
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: VA VA |
$51.31
|
|
