|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$227.26 |
| Rate for Payer: Aetna Commercial |
$204.53
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$220.44
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$227.26
|
| Rate for Payer: Healthscope Whirlpool |
$220.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$204.53
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.99
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$159.08 |
| Max. Negotiated Rate |
$227.26 |
| Rate for Payer: Aetna Commercial |
$204.53
|
| Rate for Payer: ASR ASR |
$220.44
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$227.26
|
| Rate for Payer: Healthscope Whirlpool |
$220.44
|
| Rate for Payer: Mclaren Commercial |
$204.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.99
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$159.08 |
| Max. Negotiated Rate |
$227.26 |
| Rate for Payer: Aetna Commercial |
$204.53
|
| Rate for Payer: ASR ASR |
$220.44
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$227.26
|
| Rate for Payer: Healthscope Whirlpool |
$220.44
|
| Rate for Payer: Mclaren Commercial |
$204.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.99
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$227.26 |
| Rate for Payer: Aetna Commercial |
$204.53
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$220.44
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$227.26
|
| Rate for Payer: Healthscope Whirlpool |
$220.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$204.53
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.99
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$159.08 |
| Max. Negotiated Rate |
$227.26 |
| Rate for Payer: Aetna Commercial |
$204.53
|
| Rate for Payer: ASR ASR |
$220.44
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$227.26
|
| Rate for Payer: Healthscope Whirlpool |
$220.44
|
| Rate for Payer: Mclaren Commercial |
$204.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.99
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$227.26 |
| Rate for Payer: Aetna Commercial |
$204.53
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$220.44
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$227.26
|
| Rate for Payer: Healthscope Whirlpool |
$220.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$204.53
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.99
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
IP
|
$94.70
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$66.29 |
| Max. Negotiated Rate |
$94.70 |
| Rate for Payer: Aetna Commercial |
$85.23
|
| Rate for Payer: ASR ASR |
$91.86
|
| Rate for Payer: BCBS Trust/PPO |
$73.42
|
| Rate for Payer: BCN Commercial |
$73.42
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cofinity Commercial |
$89.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.76
|
| Rate for Payer: Healthscope Commercial |
$94.70
|
| Rate for Payer: Healthscope Whirlpool |
$91.86
|
| Rate for Payer: Mclaren Commercial |
$85.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.34
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
OP
|
$94.70
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$110.83 |
| Rate for Payer: Aetna Commercial |
$85.23
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$91.86
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$73.42
|
| Rate for Payer: BCN Commercial |
$73.42
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cofinity Commercial |
$89.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$94.70
|
| Rate for Payer: Healthscope Whirlpool |
$91.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$85.23
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.50
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.34
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
|
HC FROZEN SECTION
|
Facility
|
OP
|
$124.54
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$59.93 |
| Max. Negotiated Rate |
$189.78 |
| Rate for Payer: Aetna Commercial |
$112.09
|
| Rate for Payer: Aetna Medicare |
$151.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: ASR ASR |
$120.80
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$96.56
|
| Rate for Payer: BCCCP Commercial |
$102.87
|
| Rate for Payer: BCN Commercial |
$96.56
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$117.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$124.54
|
| Rate for Payer: Healthscope Whirlpool |
$120.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.82
|
| Rate for Payer: Mclaren Commercial |
$112.09
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.86
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$167.00
|
| Rate for Payer: PHP Medicaid |
$83.05
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.60
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: VA VA |
$151.82
|
|
|
HC FROZEN SECTION
|
Facility
|
IP
|
$124.54
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.18 |
| Max. Negotiated Rate |
$124.54 |
| Rate for Payer: Aetna Commercial |
$112.09
|
| Rate for Payer: ASR ASR |
$120.80
|
| Rate for Payer: BCBS Trust/PPO |
$96.56
|
| Rate for Payer: BCN Commercial |
$96.56
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$117.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Healthscope Commercial |
$124.54
|
| Rate for Payer: Healthscope Whirlpool |
$120.80
|
| Rate for Payer: Mclaren Commercial |
$112.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.60
|
|
|
HC FRUCTOSAMINE
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC FRUCTOSAMINE
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$16.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.95
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$16.76
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$16.76
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.76
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.76
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Mclaren Medicare |
$16.76
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$15.92
|
| Rate for Payer: PACE SWMI |
$16.76
|
| Rate for Payer: PHP Commercial |
$18.44
|
| Rate for Payer: PHP Medicaid |
$9.17
|
| Rate for Payer: PHP Medicare Advantage |
$16.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$16.76
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$16.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$17.26
|
| Rate for Payer: VA VA |
$16.76
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
OP
|
$94.90
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.48 |
| Max. Negotiated Rate |
$94.90 |
| Rate for Payer: Aetna Commercial |
$85.41
|
| Rate for Payer: Aetna Medicare |
$17.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: ASR ASR |
$92.05
|
| Rate for Payer: BCBS Complete |
$9.96
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$73.58
|
| Rate for Payer: BCN Commercial |
$73.58
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$75.92
|
| Rate for Payer: Cash Price |
$75.92
|
| Rate for Payer: Cofinity Commercial |
$89.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$94.90
|
| Rate for Payer: Healthscope Whirlpool |
$92.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.34
|
| Rate for Payer: Mclaren Commercial |
$85.41
|
| Rate for Payer: Mclaren Medicaid |
$9.48
|
| Rate for Payer: Mclaren Medicare |
$17.34
|
| Rate for Payer: Meridian Medicaid |
$9.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.66
|
| Rate for Payer: PACE Medicare |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicaid |
$9.48
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.36
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow Network |
$67.38
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.51
|
| Rate for Payer: UHC Medicare Advantage |
$17.86
|
| Rate for Payer: VA VA |
$17.34
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
IP
|
$94.90
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.43 |
| Max. Negotiated Rate |
$94.90 |
| Rate for Payer: Aetna Commercial |
$85.41
|
| Rate for Payer: ASR ASR |
$92.05
|
| Rate for Payer: BCBS Trust/PPO |
$73.58
|
| Rate for Payer: BCN Commercial |
$73.58
|
| Rate for Payer: Cash Price |
$75.92
|
| Rate for Payer: Cofinity Commercial |
$89.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.92
|
| Rate for Payer: Healthscope Commercial |
$94.90
|
| Rate for Payer: Healthscope Whirlpool |
$92.05
|
| Rate for Payer: Mclaren Commercial |
$85.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.51
|
|
|
HC F/U EP STUDY
|
Facility
|
OP
|
$5,503.49
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,631.15 |
| Max. Negotiated Rate |
$8,297.88 |
| Rate for Payer: Aetna Commercial |
$4,953.14
|
| Rate for Payer: Aetna Medicare |
$6,638.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,297.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,297.88
|
| Rate for Payer: ASR ASR |
$5,338.39
|
| Rate for Payer: BCBS Complete |
$3,813.04
|
| Rate for Payer: BCBS MAPPO |
$6,638.30
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.86
|
| Rate for Payer: BCN Commercial |
$4,266.86
|
| Rate for Payer: BCN Medicare Advantage |
$6,638.30
|
| Rate for Payer: Cash Price |
$4,402.79
|
| Rate for Payer: Cash Price |
$4,402.79
|
| Rate for Payer: Cofinity Commercial |
$5,173.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,402.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,638.30
|
| Rate for Payer: Healthscope Commercial |
$5,503.49
|
| Rate for Payer: Healthscope Whirlpool |
$5,338.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,638.30
|
| Rate for Payer: Mclaren Commercial |
$4,953.14
|
| Rate for Payer: Mclaren Medicaid |
$3,631.15
|
| Rate for Payer: Mclaren Medicare |
$6,638.30
|
| Rate for Payer: Meridian Medicaid |
$3,813.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,970.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,634.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,677.97
|
| Rate for Payer: PACE Medicare |
$6,306.38
|
| Rate for Payer: PACE SWMI |
$6,638.30
|
| Rate for Payer: PHP Commercial |
$7,302.13
|
| Rate for Payer: PHP Medicaid |
$3,631.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,638.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,631.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,008.18
|
| Rate for Payer: Priority Health Medicare |
$6,638.30
|
| Rate for Payer: Priority Health Narrow Network |
$3,907.48
|
| Rate for Payer: Railroad Medicare Medicare |
$6,638.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,843.07
|
| Rate for Payer: UHC Medicare Advantage |
$6,837.45
|
| Rate for Payer: VA VA |
$6,638.30
|
|
|
HC F/U EP STUDY
|
Facility
|
IP
|
$5,503.49
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,852.44 |
| Max. Negotiated Rate |
$5,503.49 |
| Rate for Payer: Aetna Commercial |
$4,953.14
|
| Rate for Payer: ASR ASR |
$5,338.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.86
|
| Rate for Payer: BCN Commercial |
$4,266.86
|
| Rate for Payer: Cash Price |
$4,402.79
|
| Rate for Payer: Cofinity Commercial |
$5,173.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,402.79
|
| Rate for Payer: Healthscope Commercial |
$5,503.49
|
| Rate for Payer: Healthscope Whirlpool |
$5,338.39
|
| Rate for Payer: Mclaren Commercial |
$4,953.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,677.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,843.07
|
|
|
HC FUNC BACK EVAL
|
Facility
|
IP
|
$123.19
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$86.23 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Aetna Commercial |
$110.87
|
| Rate for Payer: ASR ASR |
$119.49
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$98.55
|
| Rate for Payer: Cofinity Commercial |
$115.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.55
|
| Rate for Payer: Healthscope Commercial |
$123.19
|
| Rate for Payer: Healthscope Whirlpool |
$119.49
|
| Rate for Payer: Mclaren Commercial |
$110.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.41
|
|
|
HC FUNC BACK EVAL
|
Facility
|
OP
|
$123.19
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$49.28 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Aetna Commercial |
$110.87
|
| Rate for Payer: ASR ASR |
$119.49
|
| Rate for Payer: BCBS Complete |
$49.28
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$98.55
|
| Rate for Payer: Cofinity Commercial |
$115.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.55
|
| Rate for Payer: Healthscope Commercial |
$123.19
|
| Rate for Payer: Healthscope Whirlpool |
$119.49
|
| Rate for Payer: Mclaren Commercial |
$110.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.10
|
| Rate for Payer: Priority Health Narrow Network |
$87.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.41
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
IP
|
$66.10
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.27 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$59.49
|
| Rate for Payer: ASR ASR |
$64.12
|
| Rate for Payer: BCBS Trust/PPO |
$51.25
|
| Rate for Payer: BCN Commercial |
$51.25
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$62.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Whirlpool |
$64.12
|
| Rate for Payer: Mclaren Commercial |
$59.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.17
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
OP
|
$66.10
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$59.49
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$64.12
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$51.25
|
| Rate for Payer: BCN Commercial |
$51.25
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$62.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Whirlpool |
$64.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$59.49
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.65
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.15
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$46.93
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.17
|
| Rate for Payer: UHC Medicare Advantage |
$10.63
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
IP
|
$66.10
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.27 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$59.49
|
| Rate for Payer: ASR ASR |
$64.12
|
| Rate for Payer: BCBS Trust/PPO |
$51.25
|
| Rate for Payer: BCN Commercial |
$51.25
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$62.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Whirlpool |
$64.12
|
| Rate for Payer: Mclaren Commercial |
$59.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.17
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
OP
|
$66.10
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$59.49
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$64.12
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$51.25
|
| Rate for Payer: BCN Commercial |
$51.25
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$62.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Whirlpool |
$64.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$59.49
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.65
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.15
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$46.93
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.17
|
| Rate for Payer: UHC Medicare Advantage |
$10.63
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$61.57 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.78
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Complete |
$7.71
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.42
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$7.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Medicaid |
$7.34
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.57
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$49.26
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
| Rate for Payer: UHC Medicare Advantage |
$13.82
|
| Rate for Payer: VA VA |
$13.42
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: ASR ASR |
$38.80
|
| Rate for Payer: BCBS Complete |
$7.41
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$31.01
|
| Rate for Payer: BCN Commercial |
$31.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$37.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$40.00
|
| Rate for Payer: Healthscope Whirlpool |
$38.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.90
|
| Rate for Payer: Mclaren Commercial |
$36.00
|
| Rate for Payer: Mclaren Medicaid |
$7.06
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Medicaid |
$7.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.00
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: PHP Medicaid |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$28.40
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.29
|
| Rate for Payer: VA VA |
$12.90
|
|
