|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$882.55
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$573.66 |
| Max. Negotiated Rate |
$882.55 |
| Rate for Payer: Aetna Commercial |
$794.30
|
| Rate for Payer: ASR ASR |
$856.07
|
| Rate for Payer: ASR Commercial |
$856.07
|
| Rate for Payer: BCBS Trust/PPO |
$719.19
|
| Rate for Payer: BCN Commercial |
$684.24
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cofinity Commercial |
$829.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.04
|
| Rate for Payer: Healthscope Commercial |
$882.55
|
| Rate for Payer: Healthscope Whirlpool |
$856.07
|
| Rate for Payer: Mclaren Commercial |
$794.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.17
|
| Rate for Payer: Nomi Health Commercial |
$723.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.64
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$882.55
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$174.19 |
| Max. Negotiated Rate |
$882.55 |
| Rate for Payer: Aetna Commercial |
$794.30
|
| Rate for Payer: Aetna Medicare |
$324.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: ASR ASR |
$856.07
|
| Rate for Payer: ASR Commercial |
$856.07
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$722.72
|
| Rate for Payer: BCN Commercial |
$684.24
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cofinity Commercial |
$829.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$882.55
|
| Rate for Payer: Healthscope Whirlpool |
$856.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$324.98
|
| Rate for Payer: Mclaren Commercial |
$794.30
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.17
|
| Rate for Payer: Nomi Health Commercial |
$723.69
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$357.48
|
| Rate for Payer: PHP Medicaid |
$174.19
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$773.29
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$618.67
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$503.72
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP DNSP |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: VA VA |
$324.98
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$440.24
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$286.16 |
| Max. Negotiated Rate |
$440.24 |
| Rate for Payer: Aetna Commercial |
$396.22
|
| Rate for Payer: ASR ASR |
$427.03
|
| Rate for Payer: ASR Commercial |
$427.03
|
| Rate for Payer: BCBS Trust/PPO |
$358.75
|
| Rate for Payer: BCN Commercial |
$341.32
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cofinity Commercial |
$413.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.19
|
| Rate for Payer: Healthscope Commercial |
$440.24
|
| Rate for Payer: Healthscope Whirlpool |
$427.03
|
| Rate for Payer: Mclaren Commercial |
$396.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.20
|
| Rate for Payer: Nomi Health Commercial |
$361.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.41
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$440.24
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$37.38 |
| Max. Negotiated Rate |
$440.24 |
| Rate for Payer: Aetna Commercial |
$396.22
|
| Rate for Payer: Aetna Medicare |
$69.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.16
|
| Rate for Payer: ASR ASR |
$427.03
|
| Rate for Payer: ASR Commercial |
$427.03
|
| Rate for Payer: BCBS Complete |
$39.24
|
| Rate for Payer: BCBS MAPPO |
$69.73
|
| Rate for Payer: BCBS Trust/PPO |
$360.51
|
| Rate for Payer: BCN Commercial |
$341.32
|
| Rate for Payer: BCN Medicare Advantage |
$69.73
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cofinity Commercial |
$413.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.73
|
| Rate for Payer: Healthscope Commercial |
$440.24
|
| Rate for Payer: Healthscope Whirlpool |
$427.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.73
|
| Rate for Payer: Mclaren Commercial |
$396.22
|
| Rate for Payer: Mclaren Medicaid |
$37.38
|
| Rate for Payer: Mclaren Medicare |
$69.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.22
|
| Rate for Payer: Meridian Medicaid |
$39.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.20
|
| Rate for Payer: Nomi Health Commercial |
$361.00
|
| Rate for Payer: PACE Medicare |
$66.24
|
| Rate for Payer: PACE SWMI |
$69.73
|
| Rate for Payer: PHP Commercial |
$76.70
|
| Rate for Payer: PHP Medicaid |
$37.38
|
| Rate for Payer: PHP Medicare Advantage |
$69.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.81
|
| Rate for Payer: Priority Health Medicare |
$69.73
|
| Rate for Payer: Priority Health Narrow Network |
$132.65
|
| Rate for Payer: Railroad Medicare Medicare |
$69.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.73
|
| Rate for Payer: UHC Exchange |
$108.08
|
| Rate for Payer: UHC Medicare Advantage |
$69.73
|
| Rate for Payer: UHCCP DNSP |
$69.73
|
| Rate for Payer: UHCCP Medicaid |
$37.38
|
| Rate for Payer: VA VA |
$69.73
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$174.19 |
| Max. Negotiated Rate |
$503.72 |
| Rate for Payer: Aetna Commercial |
$394.78
|
| Rate for Payer: Aetna Medicare |
$324.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$359.21
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$324.98
|
| Rate for Payer: Mclaren Commercial |
$394.78
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$357.48
|
| Rate for Payer: PHP Medicaid |
$174.19
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.35
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$307.49
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$503.72
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP DNSP |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: VA VA |
$324.98
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$438.65 |
| Rate for Payer: Aetna Commercial |
$394.78
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Trust/PPO |
$357.46
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Mclaren Commercial |
$394.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$174.19 |
| Max. Negotiated Rate |
$503.72 |
| Rate for Payer: Aetna Commercial |
$394.78
|
| Rate for Payer: Aetna Medicare |
$324.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$359.21
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$324.98
|
| Rate for Payer: Mclaren Commercial |
$394.78
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$357.48
|
| Rate for Payer: PHP Medicaid |
$174.19
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.35
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$307.49
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$503.72
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP DNSP |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: VA VA |
$324.98
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$438.65 |
| Rate for Payer: Aetna Commercial |
$394.78
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Trust/PPO |
$357.46
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Mclaren Commercial |
$394.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
OP
|
$1,560.60
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.24 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,404.54
|
| Rate for Payer: Aetna Medicare |
$780.30
|
| Rate for Payer: ASR ASR |
$1,513.78
|
| Rate for Payer: ASR Commercial |
$1,513.78
|
| Rate for Payer: BCBS Complete |
$624.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.98
|
| Rate for Payer: BCN Commercial |
$1,209.93
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,466.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,513.78
|
| Rate for Payer: Mclaren Commercial |
$1,404.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,367.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,093.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.33
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
IP
|
$1,560.60
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,014.39 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,404.54
|
| Rate for Payer: ASR ASR |
$1,513.78
|
| Rate for Payer: ASR Commercial |
$1,513.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.73
|
| Rate for Payer: BCN Commercial |
$1,209.93
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,466.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,513.78
|
| Rate for Payer: Mclaren Commercial |
$1,404.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.33
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial |
$37.80
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: ASR ASR |
$40.74
|
| Rate for Payer: ASR Commercial |
$40.74
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$34.39
|
| Rate for Payer: BCN Commercial |
$32.56
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$39.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$42.00
|
| Rate for Payer: Healthscope Whirlpool |
$40.74
|
| Rate for Payer: Mclaren Commercial |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.70
|
| Rate for Payer: Nomi Health Commercial |
$34.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.80
|
| Rate for Payer: Priority Health Narrow Network |
$29.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.96
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.30 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial |
$37.80
|
| Rate for Payer: ASR ASR |
$40.74
|
| Rate for Payer: ASR Commercial |
$40.74
|
| Rate for Payer: BCBS Trust/PPO |
$34.23
|
| Rate for Payer: BCN Commercial |
$32.56
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$39.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$42.00
|
| Rate for Payer: Healthscope Whirlpool |
$40.74
|
| Rate for Payer: Mclaren Commercial |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.70
|
| Rate for Payer: Nomi Health Commercial |
$34.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.96
|
|
|
HC CHILDHOOD ALLERGEN PROFILE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CHILDHOOD ALLERGEN PROFILE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC CHLAMYDIA AB IGG
|
Facility
|
OP
|
$18.54
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200239
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$18.54 |
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Medicare |
$11.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: ASR ASR |
$17.98
|
| Rate for Payer: ASR Commercial |
$17.98
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$15.18
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cofinity Commercial |
$17.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$18.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.82
|
| Rate for Payer: Mclaren Commercial |
$16.69
|
| Rate for Payer: Mclaren Medicaid |
$6.34
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicaid |
$6.34
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.24
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$13.00
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$18.32
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: UHCCP DNSP |
$11.82
|
| Rate for Payer: UHCCP Medicaid |
$6.34
|
| Rate for Payer: VA VA |
$11.82
|
|
|
HC CHLAMYDIA AB IGG
|
Facility
|
IP
|
$18.54
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200239
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$18.54 |
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: ASR ASR |
$17.98
|
| Rate for Payer: ASR Commercial |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$15.11
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cofinity Commercial |
$17.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$18.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.98
|
| Rate for Payer: Mclaren Commercial |
$16.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.32
|
|
|
HC CHLAMYDIA AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
30600149
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$52.43
|
| 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 |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| 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: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC CHLAMYDIA AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
30600149
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$108.71 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.38
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.71
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$86.97
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CHLAMYDIA ANTIBODIES
|
Facility
|
IP
|
$18.54
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200355
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$18.54 |
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: ASR ASR |
$17.98
|
| Rate for Payer: ASR Commercial |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$15.11
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cofinity Commercial |
$17.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$18.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.98
|
| Rate for Payer: Mclaren Commercial |
$16.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.32
|
|
|
HC CHLAMYDIA ANTIBODIES
|
Facility
|
OP
|
$18.54
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200355
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$18.54 |
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Medicare |
$11.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: ASR ASR |
$17.98
|
| Rate for Payer: ASR Commercial |
$17.98
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$15.18
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cofinity Commercial |
$17.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$18.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.82
|
| Rate for Payer: Mclaren Commercial |
$16.69
|
| Rate for Payer: Mclaren Medicaid |
$6.34
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicaid |
$6.34
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.24
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$13.00
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$18.32
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: UHCCP DNSP |
$11.82
|
| Rate for Payer: UHCCP Medicaid |
$6.34
|
| Rate for Payer: VA VA |
$11.82
|
|
|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
OP
|
$19.89
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$19.89 |
| Rate for Payer: Aetna Commercial |
$17.90
|
| Rate for Payer: Aetna Medicare |
$12.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.85
|
| Rate for Payer: ASR ASR |
$19.29
|
| Rate for Payer: ASR Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$7.14
|
| Rate for Payer: BCBS MAPPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.29
|
| Rate for Payer: BCN Commercial |
$15.42
|
| Rate for Payer: BCN Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.68
|
| Rate for Payer: Healthscope Commercial |
$19.89
|
| Rate for Payer: Healthscope Whirlpool |
$19.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.68
|
| Rate for Payer: Mclaren Commercial |
$17.90
|
| Rate for Payer: Mclaren Medicaid |
$6.80
|
| Rate for Payer: Mclaren Medicare |
$12.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.31
|
| Rate for Payer: Meridian Medicaid |
$7.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.91
|
| Rate for Payer: Nomi Health Commercial |
$16.31
|
| Rate for Payer: PACE Medicare |
$12.05
|
| Rate for Payer: PACE SWMI |
$12.68
|
| Rate for Payer: PHP Commercial |
$13.95
|
| Rate for Payer: PHP Medicaid |
$6.80
|
| Rate for Payer: PHP Medicare Advantage |
$12.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.43
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health Narrow Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.68
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicare Advantage |
$12.68
|
| Rate for Payer: UHCCP DNSP |
$12.68
|
| Rate for Payer: UHCCP Medicaid |
$6.80
|
| Rate for Payer: VA VA |
$12.68
|
|
|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
IP
|
$19.89
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$19.89 |
| Rate for Payer: Aetna Commercial |
$17.90
|
| Rate for Payer: ASR ASR |
$19.29
|
| Rate for Payer: ASR Commercial |
$19.29
|
| Rate for Payer: BCBS Trust/PPO |
$16.21
|
| Rate for Payer: BCN Commercial |
$15.42
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.91
|
| Rate for Payer: Healthscope Commercial |
$19.89
|
| Rate for Payer: Healthscope Whirlpool |
$19.29
|
| Rate for Payer: Mclaren Commercial |
$17.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.91
|
| Rate for Payer: Nomi Health Commercial |
$16.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.50
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE
|
Facility
|
OP
|
$81.60
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
30600088
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$81.60 |
| Rate for Payer: Aetna Commercial |
$73.44
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.50
|
| Rate for Payer: ASR ASR |
$79.15
|
| Rate for Payer: ASR Commercial |
$79.15
|
| Rate for Payer: BCBS Complete |
$11.03
|
| Rate for Payer: BCBS MAPPO |
$19.60
|
| Rate for Payer: BCBS Trust/PPO |
$66.82
|
| Rate for Payer: BCN Commercial |
$63.26
|
| Rate for Payer: BCN Medicare Advantage |
$19.60
|
| Rate for Payer: Cash Price |
$65.28
|
| Rate for Payer: Cash Price |
$65.28
|
| Rate for Payer: Cofinity Commercial |
$76.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.60
|
| Rate for Payer: Healthscope Commercial |
$81.60
|
| Rate for Payer: Healthscope Whirlpool |
$79.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.60
|
| Rate for Payer: Mclaren Commercial |
$73.44
|
| Rate for Payer: Mclaren Medicaid |
$10.51
|
| Rate for Payer: Mclaren Medicare |
$19.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.58
|
| Rate for Payer: Meridian Medicaid |
$11.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.36
|
| Rate for Payer: Nomi Health Commercial |
$66.91
|
| Rate for Payer: PACE Medicare |
$18.62
|
| Rate for Payer: PACE SWMI |
$19.60
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: PHP Medicaid |
$10.51
|
| Rate for Payer: PHP Medicare Advantage |
$19.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.50
|
| Rate for Payer: Priority Health Medicare |
$19.60
|
| Rate for Payer: Priority Health Narrow Network |
$57.20
|
| Rate for Payer: Railroad Medicare Medicare |
$19.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.60
|
| Rate for Payer: UHC Exchange |
$30.38
|
| Rate for Payer: UHC Medicare Advantage |
$19.60
|
| Rate for Payer: UHCCP DNSP |
$19.60
|
| Rate for Payer: UHCCP Medicaid |
$10.51
|
| Rate for Payer: VA VA |
$19.60
|
|
