|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$147.59
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$103.31 |
| Max. Negotiated Rate |
$147.59 |
| Rate for Payer: Aetna Commercial |
$132.83
|
| Rate for Payer: ASR ASR |
$143.16
|
| Rate for Payer: BCBS Trust/PPO |
$114.43
|
| Rate for Payer: BCN Commercial |
$114.43
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$138.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Healthscope Commercial |
$147.59
|
| Rate for Payer: Healthscope Whirlpool |
$143.16
|
| Rate for Payer: Mclaren Commercial |
$132.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.88
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$147.59
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$147.59 |
| Rate for Payer: Aetna Commercial |
$132.83
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$143.16
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$114.43
|
| Rate for Payer: BCN Commercial |
$114.43
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$138.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$147.59
|
| Rate for Payer: Healthscope Whirlpool |
$143.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$132.83
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.31
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$104.79
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.88
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$295.20
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$295.20 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$286.34
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$228.87
|
| Rate for Payer: BCN Commercial |
$228.87
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cofinity Commercial |
$277.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$295.20
|
| Rate for Payer: Healthscope Whirlpool |
$286.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$265.68
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.92
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.63
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$209.59
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.78
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$295.20
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$206.64 |
| Max. Negotiated Rate |
$295.20 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: ASR ASR |
$286.34
|
| Rate for Payer: BCBS Trust/PPO |
$228.87
|
| Rate for Payer: BCN Commercial |
$228.87
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cofinity Commercial |
$277.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.16
|
| Rate for Payer: Healthscope Commercial |
$295.20
|
| Rate for Payer: Healthscope Whirlpool |
$286.34
|
| Rate for Payer: Mclaren Commercial |
$265.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.78
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$383.75
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$268.62 |
| Max. Negotiated Rate |
$383.75 |
| Rate for Payer: Aetna Commercial |
$345.38
|
| Rate for Payer: ASR ASR |
$372.24
|
| Rate for Payer: BCBS Trust/PPO |
$297.52
|
| Rate for Payer: BCN Commercial |
$297.52
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$360.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Healthscope Commercial |
$383.75
|
| Rate for Payer: Healthscope Whirlpool |
$372.24
|
| Rate for Payer: Mclaren Commercial |
$345.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.70
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
OP
|
$383.75
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$383.75 |
| Rate for Payer: Aetna Commercial |
$345.38
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$372.24
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$297.52
|
| Rate for Payer: BCN Commercial |
$297.52
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$360.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$383.75
|
| Rate for Payer: Healthscope Whirlpool |
$372.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$345.38
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$349.21
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$272.46
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.70
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC HIS LEAD
|
Facility
|
OP
|
$1,413.72
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$565.49 |
| Max. Negotiated Rate |
$1,413.72 |
| Rate for Payer: Aetna Commercial |
$1,272.35
|
| Rate for Payer: ASR ASR |
$1,371.31
|
| Rate for Payer: BCBS Complete |
$565.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.06
|
| Rate for Payer: BCN Commercial |
$1,096.06
|
| Rate for Payer: Cash Price |
$1,130.98
|
| Rate for Payer: Cofinity Commercial |
$1,328.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.98
|
| Rate for Payer: Healthscope Commercial |
$1,413.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,371.31
|
| Rate for Payer: Mclaren Commercial |
$1,272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,286.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,244.07
|
|
|
HC HIS LEAD
|
Facility
|
IP
|
$1,413.72
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$989.60 |
| Max. Negotiated Rate |
$1,413.72 |
| Rate for Payer: Aetna Commercial |
$1,272.35
|
| Rate for Payer: ASR ASR |
$1,371.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.06
|
| Rate for Payer: BCN Commercial |
$1,096.06
|
| Rate for Payer: Cash Price |
$1,130.98
|
| Rate for Payer: Cofinity Commercial |
$1,328.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.98
|
| Rate for Payer: Healthscope Commercial |
$1,413.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,371.31
|
| Rate for Payer: Mclaren Commercial |
$1,272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,244.07
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$197.03 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| 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 |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.31
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.03
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$157.62
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC HISTOPLASMA AB
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.30 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: ASR ASR |
$57.23
|
| Rate for Payer: BCBS Trust/PPO |
$45.74
|
| Rate for Payer: BCN Commercial |
$45.74
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$55.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Healthscope Commercial |
$59.00
|
| Rate for Payer: Healthscope Whirlpool |
$57.23
|
| Rate for Payer: Mclaren Commercial |
$53.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.92
|
|
|
HC HISTOPLASMA AB
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: ASR ASR |
$57.23
|
| Rate for Payer: BCBS Complete |
$7.92
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$45.74
|
| Rate for Payer: BCN Commercial |
$45.74
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$55.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$59.00
|
| Rate for Payer: Healthscope Whirlpool |
$57.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.79
|
| Rate for Payer: Mclaren Commercial |
$53.10
|
| Rate for Payer: Mclaren Medicaid |
$7.54
|
| Rate for Payer: Mclaren Medicare |
$13.79
|
| Rate for Payer: Meridian Medicaid |
$7.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.15
|
| Rate for Payer: PACE Medicare |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$15.17
|
| Rate for Payer: PHP Medicaid |
$7.54
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.69
|
| Rate for Payer: Priority Health Medicare |
$13.79
|
| Rate for Payer: Priority Health Narrow Network |
$41.89
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.92
|
| Rate for Payer: UHC Medicare Advantage |
$14.20
|
| Rate for Payer: VA VA |
$13.79
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$21.17 |
| Rate for Payer: Aetna Commercial |
$19.05
|
| Rate for Payer: ASR ASR |
$20.53
|
| Rate for Payer: BCBS Trust/PPO |
$16.41
|
| Rate for Payer: BCN Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$21.17
|
| Rate for Payer: Healthscope Whirlpool |
$20.53
|
| Rate for Payer: Mclaren Commercial |
$19.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.63
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$21.17 |
| Rate for Payer: Aetna Commercial |
$19.05
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: ASR ASR |
$20.53
|
| Rate for Payer: BCBS Complete |
$7.92
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$16.41
|
| Rate for Payer: BCN Commercial |
$16.41
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$21.17
|
| Rate for Payer: Healthscope Whirlpool |
$20.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.79
|
| Rate for Payer: Mclaren Commercial |
$19.05
|
| Rate for Payer: Mclaren Medicaid |
$7.54
|
| Rate for Payer: Mclaren Medicare |
$13.79
|
| Rate for Payer: Meridian Medicaid |
$7.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: PACE Medicare |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$15.17
|
| Rate for Payer: PHP Medicaid |
$7.54
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.26
|
| Rate for Payer: Priority Health Medicare |
$13.79
|
| Rate for Payer: Priority Health Narrow Network |
$15.03
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.63
|
| Rate for Payer: UHC Medicare Advantage |
$14.20
|
| Rate for Payer: VA VA |
$13.79
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$21.17 |
| Rate for Payer: Aetna Commercial |
$19.05
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: ASR ASR |
$20.53
|
| Rate for Payer: BCBS Complete |
$7.92
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$16.41
|
| Rate for Payer: BCN Commercial |
$16.41
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$21.17
|
| Rate for Payer: Healthscope Whirlpool |
$20.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.79
|
| Rate for Payer: Mclaren Commercial |
$19.05
|
| Rate for Payer: Mclaren Medicaid |
$7.54
|
| Rate for Payer: Mclaren Medicare |
$13.79
|
| Rate for Payer: Meridian Medicaid |
$7.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: PACE Medicare |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$15.17
|
| Rate for Payer: PHP Medicaid |
$7.54
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.26
|
| Rate for Payer: Priority Health Medicare |
$13.79
|
| Rate for Payer: Priority Health Narrow Network |
$15.03
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.63
|
| Rate for Payer: UHC Medicare Advantage |
$14.20
|
| Rate for Payer: VA VA |
$13.79
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$21.17 |
| Rate for Payer: Aetna Commercial |
$19.05
|
| Rate for Payer: ASR ASR |
$20.53
|
| Rate for Payer: BCBS Trust/PPO |
$16.41
|
| Rate for Payer: BCN Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$21.17
|
| Rate for Payer: Healthscope Whirlpool |
$20.53
|
| Rate for Payer: Mclaren Commercial |
$19.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.63
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.58
|
| Rate for Payer: PHP Medicaid |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.94
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$95.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
| Rate for Payer: UHC Medicare Advantage |
$13.65
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.58
|
| Rate for Payer: PHP Medicaid |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.94
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$95.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
| Rate for Payer: UHC Medicare Advantage |
$13.65
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.58
|
| Rate for Payer: PHP Medicaid |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.94
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$95.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
| Rate for Payer: UHC Medicare Advantage |
$13.65
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC HIT ASSAY
|
Facility
|
IP
|
$173.40
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$121.38 |
| Max. Negotiated Rate |
$173.40 |
| Rate for Payer: Aetna Commercial |
$156.06
|
| Rate for Payer: ASR ASR |
$168.20
|
| Rate for Payer: BCBS Trust/PPO |
$134.44
|
| Rate for Payer: BCN Commercial |
$134.44
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$163.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Healthscope Commercial |
$173.40
|
| Rate for Payer: Healthscope Whirlpool |
$168.20
|
| Rate for Payer: Mclaren Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.59
|
|
|
HC HIT ASSAY
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$234.48 |
| Rate for Payer: Aetna Commercial |
$156.06
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$168.20
|
| Rate for Payer: BCBS Complete |
$10.55
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$134.44
|
| Rate for Payer: BCN Commercial |
$134.44
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$163.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$173.40
|
| Rate for Payer: Healthscope Whirlpool |
$168.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$10.05
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Medicaid |
$10.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$10.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.48
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$187.58
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.59
|
| Rate for Payer: UHC Medicare Advantage |
$18.92
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$24.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.10
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: BCBS Complete |
$13.83
|
| Rate for Payer: BCBS MAPPO |
$24.08
|
| Rate for Payer: BCBS Trust/PPO |
$37.96
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: BCN Medicare Advantage |
$24.08
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.08
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.08
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Mclaren Medicaid |
$13.17
|
| Rate for Payer: Mclaren Medicare |
$24.08
|
| Rate for Payer: Meridian Medicaid |
$13.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Medicare |
$22.88
|
| Rate for Payer: PACE SWMI |
$24.08
|
| Rate for Payer: PHP Commercial |
$26.49
|
| Rate for Payer: PHP Medicaid |
$13.17
|
| Rate for Payer: PHP Medicare Advantage |
$24.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.55
|
| Rate for Payer: Priority Health Medicare |
$24.08
|
| Rate for Payer: Priority Health Narrow Network |
$34.76
|
| Rate for Payer: Railroad Medicare Medicare |
$24.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Medicare Advantage |
$24.80
|
| Rate for Payer: VA VA |
$24.08
|
|
