|
HC HER2 DUAL ISH
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000065
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$214.20 |
| Max. Negotiated Rate |
$306.00 |
| Rate for Payer: Aetna Commercial |
$275.40
|
| Rate for Payer: ASR ASR |
$296.82
|
| Rate for Payer: BCBS Trust/PPO |
$237.24
|
| Rate for Payer: BCN Commercial |
$237.24
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$287.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$306.00
|
| Rate for Payer: Healthscope Whirlpool |
$296.82
|
| Rate for Payer: Mclaren Commercial |
$275.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.28
|
|
|
HC HER2 DUAL ISH
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000065
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$143.46 |
| Max. Negotiated Rate |
$399.39 |
| Rate for Payer: Aetna Commercial |
$275.40
|
| Rate for Payer: Aetna Medicare |
$319.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: ASR ASR |
$296.82
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$237.24
|
| Rate for Payer: BCCCP Commercial |
$143.46
|
| Rate for Payer: BCN Commercial |
$237.24
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$287.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$306.00
|
| Rate for Payer: Healthscope Whirlpool |
$296.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$319.51
|
| Rate for Payer: Mclaren Commercial |
$275.40
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$351.46
|
| Rate for Payer: PHP Medicaid |
$174.77
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.46
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$217.26
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.28
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: VA VA |
$319.51
|
|
|
HC HER2 DUAL ISH CMPT
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000066
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$214.20 |
| Max. Negotiated Rate |
$306.00 |
| Rate for Payer: Aetna Commercial |
$275.40
|
| Rate for Payer: ASR ASR |
$296.82
|
| Rate for Payer: BCBS Trust/PPO |
$237.24
|
| Rate for Payer: BCN Commercial |
$237.24
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$287.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$306.00
|
| Rate for Payer: Healthscope Whirlpool |
$296.82
|
| Rate for Payer: Mclaren Commercial |
$275.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.28
|
|
|
HC HER2 DUAL ISH CMPT
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000066
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$143.46 |
| Max. Negotiated Rate |
$399.39 |
| Rate for Payer: Aetna Commercial |
$275.40
|
| Rate for Payer: Aetna Medicare |
$319.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: ASR ASR |
$296.82
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$237.24
|
| Rate for Payer: BCCCP Commercial |
$143.46
|
| Rate for Payer: BCN Commercial |
$237.24
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$287.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$306.00
|
| Rate for Payer: Healthscope Whirlpool |
$296.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$319.51
|
| Rate for Payer: Mclaren Commercial |
$275.40
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$351.46
|
| Rate for Payer: PHP Medicaid |
$174.77
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.46
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$217.26
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.28
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: VA VA |
$319.51
|
|
|
HC HER-2 NEU QUANTITATIVE
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 83950
|
| Hospital Charge Code |
30100382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.23 |
| Max. Negotiated Rate |
$244.00 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Aetna Medicare |
$64.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.51
|
| Rate for Payer: ASR ASR |
$236.68
|
| Rate for Payer: BCBS Complete |
$37.00
|
| Rate for Payer: BCBS MAPPO |
$64.41
|
| Rate for Payer: BCBS Trust/PPO |
$189.17
|
| Rate for Payer: BCN Commercial |
$189.17
|
| Rate for Payer: BCN Medicare Advantage |
$64.41
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$229.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.41
|
| Rate for Payer: Healthscope Commercial |
$244.00
|
| Rate for Payer: Healthscope Whirlpool |
$236.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$64.41
|
| Rate for Payer: Mclaren Commercial |
$219.60
|
| Rate for Payer: Mclaren Medicaid |
$35.23
|
| Rate for Payer: Mclaren Medicare |
$64.41
|
| Rate for Payer: Meridian Medicaid |
$37.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: PACE Medicare |
$61.19
|
| Rate for Payer: PACE SWMI |
$64.41
|
| Rate for Payer: PHP Commercial |
$70.85
|
| Rate for Payer: PHP Medicaid |
$35.23
|
| Rate for Payer: PHP Medicare Advantage |
$64.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.04
|
| Rate for Payer: Priority Health Medicare |
$64.41
|
| Rate for Payer: Priority Health Narrow Network |
$173.24
|
| Rate for Payer: Railroad Medicare Medicare |
$64.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.72
|
| Rate for Payer: UHC Medicare Advantage |
$66.34
|
| Rate for Payer: VA VA |
$64.41
|
|
|
HC HER-2 NEU QUANTITATIVE
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 83950
|
| Hospital Charge Code |
30100382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$170.80 |
| Max. Negotiated Rate |
$244.00 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: ASR ASR |
$236.68
|
| Rate for Payer: BCBS Trust/PPO |
$189.17
|
| Rate for Payer: BCN Commercial |
$189.17
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$229.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Healthscope Commercial |
$244.00
|
| Rate for Payer: Healthscope Whirlpool |
$236.68
|
| Rate for Payer: Mclaren Commercial |
$219.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.72
|
|
|
HC HERPES PCR
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600211
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| 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 |
$69.26
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.36
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.97
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES PCR
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600211
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: BCBS Trust/PPO |
$55.36
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
HC HERPES PCR COMPONENT
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600212
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: BCBS Trust/PPO |
$55.36
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
HC HERPES PCR COMPONENT
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600212
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| 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 |
$69.26
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.36
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.97
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX IGG TYPE 1
|
Facility
|
OP
|
$48.97
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200281
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$48.97 |
| Rate for Payer: Aetna Commercial |
$44.07
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: ASR ASR |
$47.50
|
| Rate for Payer: BCBS Complete |
$7.58
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$37.97
|
| Rate for Payer: BCN Commercial |
$37.97
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$39.18
|
| Rate for Payer: Cash Price |
$39.18
|
| Rate for Payer: Cofinity Commercial |
$46.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$48.97
|
| Rate for Payer: Healthscope Whirlpool |
$47.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.19
|
| Rate for Payer: Mclaren Commercial |
$44.07
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Medicaid |
$7.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$14.51
|
| Rate for Payer: PHP Medicaid |
$7.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.78
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$24.62
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.09
|
| Rate for Payer: UHC Medicare Advantage |
$13.59
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC HERPES SIMPLEX IGG TYPE 1
|
Facility
|
IP
|
$48.97
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200281
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.28 |
| Max. Negotiated Rate |
$48.97 |
| Rate for Payer: Aetna Commercial |
$44.07
|
| Rate for Payer: ASR ASR |
$47.50
|
| Rate for Payer: BCBS Trust/PPO |
$37.97
|
| Rate for Payer: BCN Commercial |
$37.97
|
| Rate for Payer: Cash Price |
$39.18
|
| Rate for Payer: Cofinity Commercial |
$46.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.18
|
| Rate for Payer: Healthscope Commercial |
$48.97
|
| Rate for Payer: Healthscope Whirlpool |
$47.50
|
| Rate for Payer: Mclaren Commercial |
$44.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.09
|
|
|
HC HERPES SIMPLEX IGG TYPE 2
|
Facility
|
OP
|
$71.85
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200283
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$71.85 |
| Rate for Payer: Aetna Commercial |
$64.66
|
| Rate for Payer: Aetna Medicare |
$19.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: ASR ASR |
$69.69
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$71.85
|
| Rate for Payer: Healthscope Whirlpool |
$69.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.35
|
| Rate for Payer: Mclaren Commercial |
$64.66
|
| Rate for Payer: Mclaren Medicaid |
$10.58
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Medicaid |
$11.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.07
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$21.28
|
| Rate for Payer: PHP Medicaid |
$10.58
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.70
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$53.36
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.93
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HERPES SIMPLEX IGG TYPE 2
|
Facility
|
IP
|
$71.85
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200283
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.30 |
| Max. Negotiated Rate |
$71.85 |
| Rate for Payer: Aetna Commercial |
$64.66
|
| Rate for Payer: ASR ASR |
$69.69
|
| Rate for Payer: BCBS Trust/PPO |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Healthscope Commercial |
$71.85
|
| Rate for Payer: Healthscope Whirlpool |
$69.69
|
| Rate for Payer: Mclaren Commercial |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.23
|
|
|
HC HERPES SIMPLEX IGM TYPE 1&2
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200278
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| 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 |
$46.50
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$37.17
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| 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 |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC HERPES SIMPLEX IGM TYPE 1&2
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200278
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.56 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| Rate for Payer: ASR ASR |
$46.50
|
| Rate for Payer: BCBS Trust/PPO |
$37.17
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
|
|
HC HERPES SIMPLEX NON-SPECIFIC
|
Facility
|
IP
|
$38.76
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200277
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.13 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$34.88
|
| Rate for Payer: ASR ASR |
$37.60
|
| Rate for Payer: BCBS Trust/PPO |
$30.05
|
| Rate for Payer: BCN Commercial |
$30.05
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$36.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.01
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Healthscope Whirlpool |
$37.60
|
| Rate for Payer: Mclaren Commercial |
$34.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.11
|
|
|
HC HERPES SIMPLEX NON-SPECIFIC
|
Facility
|
OP
|
$38.76
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200277
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$34.88
|
| 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 |
$37.60
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$30.05
|
| Rate for Payer: BCN Commercial |
$30.05
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$36.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Healthscope Whirlpool |
$37.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$34.88
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.95
|
| 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 |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.11
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC HERPES SIMPLEX PCR
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| 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 |
$53.35
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$49.50
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.05
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$39.05
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.40
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX PCR
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: ASR ASR |
$53.35
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Healthscope Commercial |
$55.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.35
|
| Rate for Payer: Mclaren Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.40
|
|
|
HC HERPES SIMPLEX VIRUS 1 (HSV-1)
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600270
|
|
Hospital Revenue Code
|
306
|
| 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 HERPES SIMPLEX VIRUS 1 (HSV-1)
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600270
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| 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 |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| 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 |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX VIRUS CULTURE
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 87255
|
| Hospital Charge Code |
30600116
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.52 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Medicare |
$33.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.32
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Complete |
$19.45
|
| Rate for Payer: BCBS MAPPO |
$33.86
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: BCN Medicare Advantage |
$33.86
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.86
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.86
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$18.52
|
| Rate for Payer: Mclaren Medicare |
$33.86
|
| Rate for Payer: Meridian Medicaid |
$19.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Medicare |
$32.17
|
| Rate for Payer: PACE SWMI |
$33.86
|
| Rate for Payer: PHP Commercial |
$37.25
|
| Rate for Payer: PHP Medicaid |
$18.52
|
| Rate for Payer: PHP Medicare Advantage |
$33.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.49
|
| Rate for Payer: Priority Health Medicare |
$33.86
|
| Rate for Payer: Priority Health Narrow Network |
$77.99
|
| Rate for Payer: Railroad Medicare Medicare |
$33.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
| Rate for Payer: UHC Medicare Advantage |
$34.88
|
| Rate for Payer: VA VA |
$33.86
|
|
|
HC HERPES SIMPLEX VIRUS CULTURE
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 87255
|
| Hospital Charge Code |
30600116
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
|
|
HC HERPES SIMPLEX VIRUS (HSV-2)
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600271
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| 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 |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| 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 |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
