|
HC CT UPPER EXTREMITY W CON
|
Facility
|
IP
|
$1,479.33
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,109.50 |
| Max. Negotiated Rate |
$1,479.33 |
| Rate for Payer: Aetna Commercial |
$1,331.40
|
| Rate for Payer: ASR ASR |
$1,434.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,214.83
|
| Rate for Payer: BCN Commercial |
$1,214.83
|
| Rate for Payer: Cash Price |
$1,183.46
|
| Rate for Payer: Cofinity Commercial |
$1,390.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,183.46
|
| Rate for Payer: Healthscope Commercial |
$1,434.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,479.33
|
| Rate for Payer: Mclaren Commercial |
$1,331.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,257.43
|
| Rate for Payer: Nomi Health Commercial |
$1,213.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,109.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,301.81
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
OP
|
$1,479.33
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,479.33 |
| Rate for Payer: Aetna Commercial |
$1,331.40
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$1,434.95
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,219.71
|
| Rate for Payer: BCN Commercial |
$1,219.71
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,183.46
|
| Rate for Payer: Cash Price |
$1,183.46
|
| Rate for Payer: Cofinity Commercial |
$1,390.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,183.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,434.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,479.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$1,331.40
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,257.43
|
| Rate for Payer: Nomi Health Commercial |
$1,213.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,109.50
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,363.09
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.47
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,301.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
OP
|
$1,239.49
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,436.95 |
| Rate for Payer: Aetna Commercial |
$1,115.54
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$1,202.31
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.96
|
| Rate for Payer: BCN Commercial |
$1,021.96
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$991.59
|
| Rate for Payer: Cash Price |
$991.59
|
| Rate for Payer: Cofinity Commercial |
$1,165.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,202.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,115.54
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.57
|
| Rate for Payer: Nomi Health Commercial |
$1,016.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.62
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,436.95
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.56
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,090.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
IP
|
$1,239.49
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$929.62 |
| Max. Negotiated Rate |
$1,239.49 |
| Rate for Payer: Aetna Commercial |
$1,115.54
|
| Rate for Payer: ASR ASR |
$1,202.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,017.87
|
| Rate for Payer: BCN Commercial |
$1,017.87
|
| Rate for Payer: Cash Price |
$991.59
|
| Rate for Payer: Cofinity Commercial |
$1,165.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.59
|
| Rate for Payer: Healthscope Commercial |
$1,202.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.49
|
| Rate for Payer: Mclaren Commercial |
$1,115.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.57
|
| Rate for Payer: Nomi Health Commercial |
$1,016.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,090.75
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
OP
|
$1,724.67
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,724.67 |
| Rate for Payer: Aetna Commercial |
$1,552.20
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,672.93
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.99
|
| Rate for Payer: BCN Commercial |
$1,421.99
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cofinity Commercial |
$1,621.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,672.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,724.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,552.20
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.97
|
| Rate for Payer: Nomi Health Commercial |
$1,414.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,293.50
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,520.46
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.37
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
IP
|
$1,724.67
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,293.50 |
| Max. Negotiated Rate |
$1,724.67 |
| Rate for Payer: Aetna Commercial |
$1,552.20
|
| Rate for Payer: ASR ASR |
$1,672.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,416.30
|
| Rate for Payer: BCN Commercial |
$1,416.30
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cofinity Commercial |
$1,621.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.74
|
| Rate for Payer: Healthscope Commercial |
$1,672.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,724.67
|
| Rate for Payer: Mclaren Commercial |
$1,552.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.97
|
| Rate for Payer: Nomi Health Commercial |
$1,414.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,293.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.71
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
IP
|
$1,034.26
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$775.70 |
| Max. Negotiated Rate |
$1,034.26 |
| Rate for Payer: Aetna Commercial |
$930.83
|
| Rate for Payer: ASR ASR |
$1,003.23
|
| Rate for Payer: BCBS Trust/PPO |
$849.33
|
| Rate for Payer: BCN Commercial |
$849.33
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cofinity Commercial |
$972.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.41
|
| Rate for Payer: Healthscope Commercial |
$1,003.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,034.26
|
| Rate for Payer: Mclaren Commercial |
$930.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$879.12
|
| Rate for Payer: Nomi Health Commercial |
$848.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$910.15
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
OP
|
$1,034.26
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,034.26 |
| Rate for Payer: Aetna Commercial |
$930.83
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,003.23
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$852.75
|
| Rate for Payer: BCN Commercial |
$852.75
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cofinity Commercial |
$972.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,003.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,034.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$930.83
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$879.12
|
| Rate for Payer: Nomi Health Commercial |
$848.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.70
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$906.22
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$725.02
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$910.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
IP
|
$1,312.26
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$984.20 |
| Max. Negotiated Rate |
$1,312.26 |
| Rate for Payer: Aetna Commercial |
$1,181.03
|
| Rate for Payer: ASR ASR |
$1,272.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.63
|
| Rate for Payer: BCN Commercial |
$1,077.63
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Commercial |
$1,233.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Healthscope Commercial |
$1,272.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.26
|
| Rate for Payer: Mclaren Commercial |
$1,181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$1,076.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,154.79
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
OP
|
$1,312.26
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,312.26 |
| Rate for Payer: Aetna Commercial |
$1,181.03
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,272.89
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,081.96
|
| Rate for Payer: BCN Commercial |
$1,081.96
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Commercial |
$1,233.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,272.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,181.03
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$1,076.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,149.80
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$919.89
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,154.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
OP
|
$1,312.26
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,312.26 |
| Rate for Payer: Aetna Commercial |
$1,181.03
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$1,272.89
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,081.96
|
| Rate for Payer: BCN Commercial |
$1,081.96
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Commercial |
$1,233.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,272.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$1,181.03
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$1,076.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,149.80
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$919.89
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,154.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
IP
|
$1,312.26
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$984.20 |
| Max. Negotiated Rate |
$1,312.26 |
| Rate for Payer: Aetna Commercial |
$1,181.03
|
| Rate for Payer: ASR ASR |
$1,272.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.63
|
| Rate for Payer: BCN Commercial |
$1,077.63
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Commercial |
$1,233.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Healthscope Commercial |
$1,272.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.26
|
| Rate for Payer: Mclaren Commercial |
$1,181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$1,076.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,154.79
|
|
|
HC CTX BETA CROSSLAPS, S
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
30100768
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.42 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$37.69
|
| Rate for Payer: BCN Commercial |
$37.69
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$44.52
|
| Rate for Payer: Healthscope Whirlpool |
$45.90
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC CTX BETA CROSSLAPS, S
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
30100768
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$253.00 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$18.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.35
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$18.68
|
| Rate for Payer: BCBS Trust/PPO |
$37.84
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: BCN Medicare Advantage |
$18.68
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$44.52
|
| Rate for Payer: Healthscope Whirlpool |
$45.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.68
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$18.68
|
| Rate for Payer: Mclaren Medicare |
$18.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.61
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.42
|
| Rate for Payer: PACE Medicare |
$17.75
|
| Rate for Payer: PACE SWMI |
$18.68
|
| Rate for Payer: PHP Commercial |
$20.55
|
| Rate for Payer: PHP Medicaid |
$10.01
|
| Rate for Payer: PHP Medicare Advantage |
$18.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$253.00
|
| Rate for Payer: Priority Health Medicare |
$18.68
|
| Rate for Payer: Priority Health Narrow Network |
$202.40
|
| Rate for Payer: Railroad Medicare Medicare |
$18.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.68
|
| Rate for Payer: UHC Exchange |
$28.95
|
| Rate for Payer: UHC Medicaid |
$9.77
|
| Rate for Payer: UHCCP DNSP |
$18.68
|
| Rate for Payer: UHCCP Medicaid |
$9.77
|
| Rate for Payer: VA VA |
$18.68
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
OP
|
$2,698.29
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$4,486.12 |
| Rate for Payer: Aetna Commercial |
$2,428.46
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$2,617.34
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.74
|
| Rate for Payer: BCN Commercial |
$2,224.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cofinity Commercial |
$2,536.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,158.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,617.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,698.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$2,428.46
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,293.55
|
| Rate for Payer: Nomi Health Commercial |
$2,212.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.72
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,364.24
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,891.50
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,374.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
IP
|
$2,698.29
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,023.72 |
| Max. Negotiated Rate |
$2,698.29 |
| Rate for Payer: Aetna Commercial |
$2,428.46
|
| Rate for Payer: ASR ASR |
$2,617.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,215.84
|
| Rate for Payer: BCN Commercial |
$2,215.84
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cofinity Commercial |
$2,536.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,158.63
|
| Rate for Payer: Healthscope Commercial |
$2,617.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,698.29
|
| Rate for Payer: Mclaren Commercial |
$2,428.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,293.55
|
| Rate for Payer: Nomi Health Commercial |
$2,212.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,374.50
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
IP
|
$53.39
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$53.39 |
| Rate for Payer: Aetna Commercial |
$48.05
|
| Rate for Payer: ASR ASR |
$51.79
|
| Rate for Payer: BCBS Trust/PPO |
$43.84
|
| Rate for Payer: BCN Commercial |
$43.84
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Healthscope Commercial |
$51.79
|
| Rate for Payer: Healthscope Whirlpool |
$53.39
|
| Rate for Payer: Mclaren Commercial |
$48.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$43.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.98
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
OP
|
$53.39
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$53.39 |
| Rate for Payer: Aetna Commercial |
$48.05
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: ASR ASR |
$51.79
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$44.02
|
| Rate for Payer: BCN Commercial |
$44.02
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$51.79
|
| Rate for Payer: Healthscope Whirlpool |
$53.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.08
|
| Rate for Payer: Mclaren Commercial |
$48.05
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: Meridian Medicaid |
$4.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$43.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$8.89
|
| Rate for Payer: PHP Medicaid |
$4.33
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.84
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health Narrow Network |
$22.27
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.08
|
| Rate for Payer: UHC Exchange |
$12.52
|
| Rate for Payer: UHC Medicaid |
$4.23
|
| Rate for Payer: UHCCP DNSP |
$8.08
|
| Rate for Payer: UHCCP Medicaid |
$4.23
|
| Rate for Payer: VA VA |
$8.08
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
IP
|
$42.49
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.87 |
| Max. Negotiated Rate |
$42.49 |
| Rate for Payer: Aetna Commercial |
$38.24
|
| Rate for Payer: ASR ASR |
$41.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: Cash Price |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$39.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.99
|
| Rate for Payer: Healthscope Commercial |
$41.22
|
| Rate for Payer: Healthscope Whirlpool |
$42.49
|
| Rate for Payer: Mclaren Commercial |
$38.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.12
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.39
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
OP
|
$42.49
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$42.49 |
| Rate for Payer: Aetna Commercial |
$38.24
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$41.22
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$35.03
|
| Rate for Payer: BCN Commercial |
$35.03
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$33.99
|
| Rate for Payer: Cash Price |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$39.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$41.22
|
| Rate for Payer: Healthscope Whirlpool |
$42.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$38.24
|
| Rate for Payer: Mclaren Medicaid |
$9.44
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.12
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.87
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32.68
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$26.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicaid |
$4.94
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
IP
|
$15.96
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$15.96 |
| Rate for Payer: Aetna Commercial |
$14.36
|
| Rate for Payer: ASR ASR |
$15.48
|
| Rate for Payer: BCBS Trust/PPO |
$13.11
|
| Rate for Payer: BCN Commercial |
$13.11
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$15.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.77
|
| Rate for Payer: Healthscope Commercial |
$15.48
|
| Rate for Payer: Healthscope Whirlpool |
$15.96
|
| Rate for Payer: Mclaren Commercial |
$14.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Nomi Health Commercial |
$13.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.04
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
OP
|
$15.96
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$32.68 |
| Rate for Payer: Aetna Commercial |
$14.36
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$15.48
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$13.16
|
| Rate for Payer: BCN Commercial |
$13.16
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$15.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$15.48
|
| Rate for Payer: Healthscope Whirlpool |
$15.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$14.36
|
| Rate for Payer: Mclaren Medicaid |
$9.44
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Nomi Health Commercial |
$13.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.97
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32.68
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$26.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicaid |
$4.94
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$82.19 |
| Rate for Payer: Aetna Commercial |
$73.97
|
| Rate for Payer: Aetna Medicare |
$8.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.51
|
| Rate for Payer: ASR ASR |
$79.72
|
| Rate for Payer: BCBS Complete |
$4.62
|
| Rate for Payer: BCBS MAPPO |
$8.41
|
| Rate for Payer: BCBS Trust/PPO |
$67.77
|
| Rate for Payer: BCN Commercial |
$67.77
|
| Rate for Payer: BCN Medicare Advantage |
$8.41
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$77.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.41
|
| Rate for Payer: Healthscope Commercial |
$79.72
|
| Rate for Payer: Healthscope Whirlpool |
$82.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.41
|
| Rate for Payer: Mclaren Commercial |
$73.97
|
| Rate for Payer: Mclaren Medicaid |
$8.41
|
| Rate for Payer: Mclaren Medicare |
$8.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.83
|
| Rate for Payer: Meridian Medicaid |
$4.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Medicare |
$7.99
|
| Rate for Payer: PACE SWMI |
$8.41
|
| Rate for Payer: PHP Commercial |
$9.25
|
| Rate for Payer: PHP Medicaid |
$4.51
|
| Rate for Payer: PHP Medicare Advantage |
$8.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.01
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$8.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.41
|
| Rate for Payer: UHC Exchange |
$13.04
|
| Rate for Payer: UHC Medicaid |
$4.40
|
| Rate for Payer: UHCCP DNSP |
$8.41
|
| Rate for Payer: UHCCP Medicaid |
$4.40
|
| Rate for Payer: VA VA |
$8.41
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$61.64 |
| Max. Negotiated Rate |
$82.19 |
| Rate for Payer: Aetna Commercial |
$73.97
|
| Rate for Payer: ASR ASR |
$79.72
|
| Rate for Payer: BCBS Trust/PPO |
$67.49
|
| Rate for Payer: BCN Commercial |
$67.49
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$77.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$79.72
|
| Rate for Payer: Healthscope Whirlpool |
$82.19
|
| Rate for Payer: Mclaren Commercial |
$73.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.33
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$123.48 |
| Rate for Payer: Aetna Commercial |
$73.97
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.64
|
| Rate for Payer: ASR ASR |
$79.72
|
| Rate for Payer: BCBS Complete |
$4.23
|
| Rate for Payer: BCBS MAPPO |
$7.71
|
| Rate for Payer: BCBS Trust/PPO |
$67.77
|
| Rate for Payer: BCN Commercial |
$67.77
|
| Rate for Payer: BCN Medicare Advantage |
$7.71
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$77.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$79.72
|
| Rate for Payer: Healthscope Whirlpool |
$82.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.71
|
| Rate for Payer: Mclaren Commercial |
$73.97
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$7.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: Meridian Medicaid |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Medicare |
$7.32
|
| Rate for Payer: PACE SWMI |
$7.71
|
| Rate for Payer: PHP Commercial |
$8.48
|
| Rate for Payer: PHP Medicaid |
$4.13
|
| Rate for Payer: PHP Medicare Advantage |
$7.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$123.48
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health Narrow Network |
$98.78
|
| Rate for Payer: Railroad Medicare Medicare |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.71
|
| Rate for Payer: UHC Exchange |
$11.95
|
| Rate for Payer: UHC Medicaid |
$4.03
|
| Rate for Payer: UHCCP DNSP |
$7.71
|
| Rate for Payer: UHCCP Medicaid |
$4.03
|
| Rate for Payer: VA VA |
$7.71
|
|
