|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$247.62
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$185.72 |
| Max. Negotiated Rate |
$247.62 |
| Rate for Payer: Aetna Commercial |
$222.86
|
| Rate for Payer: ASR ASR |
$240.19
|
| Rate for Payer: BCBS Trust/PPO |
$203.35
|
| Rate for Payer: BCN Commercial |
$203.35
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$232.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Healthscope Commercial |
$240.19
|
| Rate for Payer: Healthscope Whirlpool |
$247.62
|
| Rate for Payer: Mclaren Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Nomi Health Commercial |
$203.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.91
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$247.62
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$247.62 |
| Rate for Payer: Aetna Commercial |
$222.86
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$240.19
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$204.16
|
| Rate for Payer: BCN Commercial |
$204.16
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$232.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$240.19
|
| Rate for Payer: Healthscope Whirlpool |
$247.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$222.86
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Nomi Health Commercial |
$203.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$216.96
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$173.58
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| 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 |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| 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 |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$114.13
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$114.13 |
| Rate for Payer: Aetna Commercial |
$102.72
|
| Rate for Payer: ASR ASR |
$110.71
|
| Rate for Payer: BCBS Trust/PPO |
$93.72
|
| Rate for Payer: BCN Commercial |
$93.72
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cofinity Commercial |
$107.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.30
|
| Rate for Payer: Healthscope Commercial |
$110.71
|
| Rate for Payer: Healthscope Whirlpool |
$114.13
|
| Rate for Payer: Mclaren Commercial |
$102.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.01
|
| Rate for Payer: Nomi Health Commercial |
$93.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.43
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$114.13
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$151.32 |
| Rate for Payer: Aetna Commercial |
$102.72
|
| Rate for Payer: Aetna Medicare |
$19.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: ASR ASR |
$110.71
|
| Rate for Payer: BCBS Complete |
$10.74
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCBS Trust/PPO |
$94.10
|
| Rate for Payer: BCN Commercial |
$94.10
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cofinity Commercial |
$107.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$110.71
|
| Rate for Payer: Healthscope Whirlpool |
$114.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.56
|
| Rate for Payer: Mclaren Commercial |
$102.72
|
| Rate for Payer: Mclaren Medicaid |
$19.56
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Medicaid |
$10.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.01
|
| Rate for Payer: Nomi Health Commercial |
$93.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.60
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$21.52
|
| Rate for Payer: PHP Medicaid |
$10.48
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$151.32
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health Narrow Network |
$121.05
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.56
|
| Rate for Payer: UHC Exchange |
$30.32
|
| Rate for Payer: UHC Medicaid |
$10.23
|
| Rate for Payer: UHCCP DNSP |
$19.56
|
| Rate for Payer: UHCCP Medicaid |
$10.23
|
| Rate for Payer: VA VA |
$19.56
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$56.91 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$14.39
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$7.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.91
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$45.53
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.39
|
| Rate for Payer: UHC Exchange |
$22.30
|
| Rate for Payer: UHC Medicaid |
$7.53
|
| Rate for Payer: UHCCP DNSP |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.53
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$58.11 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$9.25
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$16.85
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.11
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$46.49
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.85
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHCCP DNSP |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$137.11
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$205.79 |
| Rate for Payer: Aetna Commercial |
$123.40
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: ASR ASR |
$133.00
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$113.05
|
| Rate for Payer: BCN Commercial |
$113.05
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cofinity Commercial |
$128.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$133.00
|
| Rate for Payer: Healthscope Whirlpool |
$137.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.92
|
| Rate for Payer: Mclaren Commercial |
$123.40
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$28.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.54
|
| Rate for Payer: Nomi Health Commercial |
$112.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.83
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicaid |
$27.83
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$205.79
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health Narrow Network |
$164.63
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.48
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$51.92
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$137.11
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$102.83 |
| Max. Negotiated Rate |
$137.11 |
| Rate for Payer: Aetna Commercial |
$123.40
|
| Rate for Payer: ASR ASR |
$133.00
|
| Rate for Payer: BCBS Trust/PPO |
$112.59
|
| Rate for Payer: BCN Commercial |
$112.59
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cofinity Commercial |
$128.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.69
|
| Rate for Payer: Healthscope Commercial |
$133.00
|
| Rate for Payer: Healthscope Whirlpool |
$137.11
|
| Rate for Payer: Mclaren Commercial |
$123.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.54
|
| Rate for Payer: Nomi Health Commercial |
$112.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.66
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$104.46
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$78.34 |
| Max. Negotiated Rate |
$104.46 |
| Rate for Payer: Aetna Commercial |
$94.01
|
| Rate for Payer: ASR ASR |
$101.33
|
| Rate for Payer: BCBS Trust/PPO |
$85.78
|
| Rate for Payer: BCN Commercial |
$85.78
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cofinity Commercial |
$98.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.57
|
| Rate for Payer: Healthscope Commercial |
$101.33
|
| Rate for Payer: Healthscope Whirlpool |
$104.46
|
| Rate for Payer: Mclaren Commercial |
$94.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.79
|
| Rate for Payer: Nomi Health Commercial |
$85.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.92
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$104.46
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$104.46 |
| Rate for Payer: Aetna Commercial |
$94.01
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$101.33
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$86.13
|
| Rate for Payer: BCN Commercial |
$86.13
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cofinity Commercial |
$98.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$101.33
|
| Rate for Payer: Healthscope Whirlpool |
$104.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$94.01
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.79
|
| Rate for Payer: Nomi Health Commercial |
$85.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.34
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$91.53
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$73.23
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$72.90
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$78.57
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$66.78
|
| Rate for Payer: BCN Commercial |
$66.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$76.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$78.57
|
| Rate for Payer: Healthscope Whirlpool |
$81.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$72.90
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$60.75 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$72.90
|
| Rate for Payer: ASR ASR |
$78.57
|
| Rate for Payer: BCBS Trust/PPO |
$66.52
|
| Rate for Payer: BCN Commercial |
$66.52
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$76.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$78.57
|
| Rate for Payer: Healthscope Whirlpool |
$81.00
|
| Rate for Payer: Mclaren Commercial |
$72.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.28
|
|
|
HC DAMAGED TYPE III HOME STUDY DEVICE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.45
|
| Rate for Payer: BCN Commercial |
$82.45
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Healthscope Whirlpool |
$100.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.62
|
| Rate for Payer: Priority Health Narrow Network |
$70.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC DAMAGED TYPE III HOME STUDY DEVICE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.12
|
| Rate for Payer: BCN Commercial |
$82.12
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Healthscope Whirlpool |
$100.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$814.63
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$610.97 |
| Max. Negotiated Rate |
$814.63 |
| Rate for Payer: Aetna Commercial |
$733.17
|
| Rate for Payer: ASR ASR |
$790.19
|
| Rate for Payer: BCBS Trust/PPO |
$668.97
|
| Rate for Payer: BCN Commercial |
$668.97
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cofinity Commercial |
$765.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.70
|
| Rate for Payer: Healthscope Commercial |
$790.19
|
| Rate for Payer: Healthscope Whirlpool |
$814.63
|
| Rate for Payer: Mclaren Commercial |
$733.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$692.44
|
| Rate for Payer: Nomi Health Commercial |
$668.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$716.87
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
OP
|
$814.63
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$357.65 |
| Max. Negotiated Rate |
$1,059.97 |
| Rate for Payer: Aetna Commercial |
$733.17
|
| Rate for Payer: Aetna Medicare |
$683.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: ASR ASR |
$790.19
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCBS Trust/PPO |
$671.66
|
| Rate for Payer: BCN Commercial |
$671.66
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cofinity Commercial |
$765.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$790.19
|
| Rate for Payer: Healthscope Whirlpool |
$814.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$683.85
|
| Rate for Payer: Mclaren Commercial |
$733.17
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$375.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$692.44
|
| Rate for Payer: Nomi Health Commercial |
$668.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.97
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$752.24
|
| Rate for Payer: PHP Medicaid |
$366.54
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$713.78
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health Narrow Network |
$571.06
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$716.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$1,059.97
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP DNSP |
$683.85
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: VA VA |
$683.85
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$872.14
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$654.11 |
| Max. Negotiated Rate |
$872.14 |
| Rate for Payer: Aetna Commercial |
$784.93
|
| Rate for Payer: ASR ASR |
$845.98
|
| Rate for Payer: BCBS Trust/PPO |
$716.20
|
| Rate for Payer: BCN Commercial |
$716.20
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cofinity Commercial |
$819.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.71
|
| Rate for Payer: Healthscope Commercial |
$845.98
|
| Rate for Payer: Healthscope Whirlpool |
$872.14
|
| Rate for Payer: Mclaren Commercial |
$784.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.32
|
| Rate for Payer: Nomi Health Commercial |
$715.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$767.48
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$872.14
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$357.65 |
| Max. Negotiated Rate |
$1,059.97 |
| Rate for Payer: Aetna Commercial |
$784.93
|
| Rate for Payer: Aetna Medicare |
$683.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: ASR ASR |
$845.98
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCBS Trust/PPO |
$719.08
|
| Rate for Payer: BCN Commercial |
$719.08
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cofinity Commercial |
$819.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$845.98
|
| Rate for Payer: Healthscope Whirlpool |
$872.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$683.85
|
| Rate for Payer: Mclaren Commercial |
$784.93
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$375.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.32
|
| Rate for Payer: Nomi Health Commercial |
$715.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.11
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$752.24
|
| Rate for Payer: PHP Medicaid |
$366.54
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$764.17
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health Narrow Network |
$611.37
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$767.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$1,059.97
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP DNSP |
$683.85
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: VA VA |
$683.85
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$799.09
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.66 |
| Max. Negotiated Rate |
$799.09 |
| Rate for Payer: Aetna Commercial |
$719.18
|
| Rate for Payer: Aetna Medicare |
$295.66
|
| Rate for Payer: ASR ASR |
$775.12
|
| Rate for Payer: BCBS Complete |
$319.64
|
| Rate for Payer: BCBS Trust/PPO |
$658.85
|
| Rate for Payer: BCN Commercial |
$658.85
|
| Rate for Payer: Cash Price |
$639.27
|
| Rate for Payer: Cofinity Commercial |
$751.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$639.27
|
| Rate for Payer: Healthscope Commercial |
$775.12
|
| Rate for Payer: Healthscope Whirlpool |
$799.09
|
| Rate for Payer: Mclaren Commercial |
$719.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$639.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.23
|
| Rate for Payer: Nomi Health Commercial |
$655.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$700.16
|
| Rate for Payer: Priority Health Narrow Network |
$560.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$703.20
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$799.09
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$599.32 |
| Max. Negotiated Rate |
$799.09 |
| Rate for Payer: Aetna Commercial |
$719.18
|
| Rate for Payer: ASR ASR |
$775.12
|
| Rate for Payer: BCBS Trust/PPO |
$656.21
|
| Rate for Payer: BCN Commercial |
$656.21
|
| Rate for Payer: Cash Price |
$639.27
|
| Rate for Payer: Cofinity Commercial |
$751.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$639.27
|
| Rate for Payer: Healthscope Commercial |
$775.12
|
| Rate for Payer: Healthscope Whirlpool |
$799.09
|
| Rate for Payer: Mclaren Commercial |
$719.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.23
|
| Rate for Payer: Nomi Health Commercial |
$655.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$703.20
|
|
|
HC D & C
|
Facility
|
OP
|
$2,082.24
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$770.43 |
| Max. Negotiated Rate |
$2,082.24 |
| Rate for Payer: Aetna Commercial |
$1,874.02
|
| Rate for Payer: Aetna Medicare |
$770.43
|
| Rate for Payer: ASR ASR |
$2,019.77
|
| Rate for Payer: BCBS Complete |
$832.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.81
|
| Rate for Payer: BCN Commercial |
$1,716.81
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cofinity Commercial |
$1,957.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.79
|
| Rate for Payer: Healthscope Commercial |
$2,019.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,082.24
|
| Rate for Payer: Mclaren Commercial |
$1,874.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,665.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.90
|
| Rate for Payer: Nomi Health Commercial |
$1,707.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,824.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,459.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,832.37
|
|
