|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,524.94
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,609.98 |
| Max. Negotiated Rate |
$6,524.94 |
| Rate for Payer: Aetna Commercial |
$5,872.45
|
| Rate for Payer: Aetna Medicare |
$3,262.47
|
| Rate for Payer: ASR ASR |
$6,329.19
|
| Rate for Payer: ASR Commercial |
$6,329.19
|
| Rate for Payer: BCBS Complete |
$2,609.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,343.27
|
| Rate for Payer: BCN Commercial |
$5,058.79
|
| Rate for Payer: Cash Price |
$5,219.95
|
| Rate for Payer: Cofinity Commercial |
$6,133.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,219.95
|
| Rate for Payer: Healthscope Commercial |
$6,524.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,329.19
|
| Rate for Payer: Mclaren Commercial |
$5,872.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.20
|
| Rate for Payer: Nomi Health Commercial |
$5,350.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,717.15
|
| Rate for Payer: Priority Health Narrow Network |
$4,573.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,741.95
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.68
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: ASR Commercial |
$68.63
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCBS Trust/PPO |
$57.94
|
| Rate for Payer: BCN Commercial |
$54.85
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$70.75
|
| Rate for Payer: Healthscope Whirlpool |
$68.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.13
|
| Rate for Payer: Mclaren Commercial |
$63.68
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$46.34
|
| Rate for Payer: PHP Medicaid |
$22.58
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.24
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health Narrow Network |
$38.59
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.13
|
| Rate for Payer: UHC Exchange |
$65.30
|
| Rate for Payer: UHC Medicare Advantage |
$42.13
|
| Rate for Payer: UHCCP DNSP |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
| Rate for Payer: VA VA |
$42.13
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.68
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: ASR Commercial |
$68.63
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCN Commercial |
$54.85
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$70.75
|
| Rate for Payer: Healthscope Whirlpool |
$68.63
|
| Rate for Payer: Mclaren Commercial |
$63.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
|
|
HC COVID 19 PCR
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: ASR Commercial |
$121.10
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$102.24
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$124.85
|
| Rate for Payer: Healthscope Whirlpool |
$121.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.74
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$46.99
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC COVID 19 PCR
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: ASR Commercial |
$121.10
|
| Rate for Payer: BCBS Trust/PPO |
$101.74
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$124.85
|
| Rate for Payer: Healthscope Whirlpool |
$121.10
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
OP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$146.33
|
| Rate for Payer: ASR Commercial |
$146.33
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$123.54
|
| Rate for Payer: BCN Commercial |
$116.96
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$141.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$150.86
|
| Rate for Payer: Healthscope Whirlpool |
$146.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$135.77
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.74
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$46.99
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
IP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$98.06 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: ASR ASR |
$146.33
|
| Rate for Payer: ASR Commercial |
$146.33
|
| Rate for Payer: BCBS Trust/PPO |
$122.94
|
| Rate for Payer: BCN Commercial |
$116.96
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$141.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$150.86
|
| Rate for Payer: Healthscope Whirlpool |
$146.33
|
| Rate for Payer: Mclaren Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.76
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$165.68 |
| Max. Negotiated Rate |
$254.90 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: ASR ASR |
$247.25
|
| Rate for Payer: ASR Commercial |
$247.25
|
| Rate for Payer: BCBS Trust/PPO |
$207.72
|
| Rate for Payer: BCN Commercial |
$197.62
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$239.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$254.90
|
| Rate for Payer: Healthscope Whirlpool |
$247.25
|
| Rate for Payer: Mclaren Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.31
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$76.45 |
| Max. Negotiated Rate |
$254.90 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: Aetna Medicare |
$142.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: ASR ASR |
$247.25
|
| Rate for Payer: ASR Commercial |
$247.25
|
| Rate for Payer: BCBS Complete |
$80.27
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$208.74
|
| Rate for Payer: BCN Commercial |
$197.62
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$239.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$254.90
|
| Rate for Payer: Healthscope Whirlpool |
$247.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$142.63
|
| Rate for Payer: Mclaren Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$76.45
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: Meridian Medicaid |
$80.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$156.89
|
| Rate for Payer: PHP Medicaid |
$76.45
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.34
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health Narrow Network |
$178.68
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.63
|
| Rate for Payer: UHC Exchange |
$221.08
|
| Rate for Payer: UHC Medicare Advantage |
$142.63
|
| Rate for Payer: UHCCP DNSP |
$142.63
|
| Rate for Payer: UHCCP Medicaid |
$76.45
|
| Rate for Payer: VA VA |
$142.63
|
|
|
HC COXIELLA BURNETTI ANTIBODY CMP
|
Facility
|
OP
|
$43.70
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$39.33
|
| Rate for Payer: Aetna Medicare |
$12.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.15
|
| Rate for Payer: ASR ASR |
$42.39
|
| Rate for Payer: ASR Commercial |
$42.39
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$12.12
|
| Rate for Payer: BCBS Trust/PPO |
$35.79
|
| Rate for Payer: BCN Commercial |
$33.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.12
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$41.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.12
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Healthscope Whirlpool |
$42.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.12
|
| Rate for Payer: Mclaren Commercial |
$39.33
|
| Rate for Payer: Mclaren Medicaid |
$6.50
|
| Rate for Payer: Mclaren Medicare |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.73
|
| Rate for Payer: Meridian Medicaid |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.14
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PACE Medicare |
$11.51
|
| Rate for Payer: PACE SWMI |
$12.12
|
| Rate for Payer: PHP Commercial |
$13.33
|
| Rate for Payer: PHP Medicaid |
$6.50
|
| Rate for Payer: PHP Medicare Advantage |
$12.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.29
|
| Rate for Payer: Priority Health Medicare |
$12.12
|
| Rate for Payer: Priority Health Narrow Network |
$30.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.12
|
| Rate for Payer: UHC Exchange |
$18.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.12
|
| Rate for Payer: UHCCP DNSP |
$12.12
|
| Rate for Payer: UHCCP Medicaid |
$6.50
|
| Rate for Payer: VA VA |
$12.12
|
|
|
HC COXIELLA BURNETTI ANTIBODY CMP
|
Facility
|
IP
|
$43.70
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$39.33
|
| Rate for Payer: ASR ASR |
$42.39
|
| Rate for Payer: ASR Commercial |
$42.39
|
| Rate for Payer: BCBS Trust/PPO |
$35.61
|
| Rate for Payer: BCN Commercial |
$33.88
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$41.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Healthscope Whirlpool |
$42.39
|
| Rate for Payer: Mclaren Commercial |
$39.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.14
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.46
|
|
|
HC COXSACKIE A AB CMPT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200266
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC COXSACKIE A AB CMPT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200266
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Exchange |
$20.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP DNSP |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$6.98
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC COXSACKIE B AB CMPT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC COXSACKIE B AB CMPT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Exchange |
$20.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.03
|
| Rate for Payer: UHCCP DNSP |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$6.98
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$37.45 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: ASR ASR |
$36.33
|
| Rate for Payer: ASR Commercial |
$36.33
|
| Rate for Payer: BCBS Trust/PPO |
$30.52
|
| Rate for Payer: BCN Commercial |
$29.03
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$35.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$37.45
|
| Rate for Payer: Healthscope Whirlpool |
$36.33
|
| Rate for Payer: Mclaren Commercial |
$33.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.96
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$64.78 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$36.33
|
| Rate for Payer: ASR Commercial |
$36.33
|
| Rate for Payer: BCBS Complete |
$11.71
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$30.67
|
| Rate for Payer: BCN Commercial |
$29.03
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$35.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$37.45
|
| Rate for Payer: Healthscope Whirlpool |
$36.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$33.70
|
| Rate for Payer: Mclaren Medicaid |
$11.15
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.15
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$51.82
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.81
|
| Rate for Payer: UHC Exchange |
$32.26
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP DNSP |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$11.15
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CPK
|
Facility
|
IP
|
$53.26
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.62 |
| Max. Negotiated Rate |
$53.26 |
| Rate for Payer: Aetna Commercial |
$47.93
|
| Rate for Payer: ASR ASR |
$51.66
|
| Rate for Payer: ASR Commercial |
$51.66
|
| Rate for Payer: BCBS Trust/PPO |
$43.40
|
| Rate for Payer: BCN Commercial |
$41.29
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cofinity Commercial |
$50.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.61
|
| Rate for Payer: Healthscope Commercial |
$53.26
|
| Rate for Payer: Healthscope Whirlpool |
$51.66
|
| Rate for Payer: Mclaren Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.27
|
| Rate for Payer: Nomi Health Commercial |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.87
|
|
|
HC CPK
|
Facility
|
OP
|
$53.26
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$53.26 |
| Rate for Payer: Aetna Commercial |
$47.93
|
| Rate for Payer: Aetna Medicare |
$6.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.14
|
| Rate for Payer: ASR ASR |
$51.66
|
| Rate for Payer: ASR Commercial |
$51.66
|
| Rate for Payer: BCBS Complete |
$3.66
|
| Rate for Payer: BCBS MAPPO |
$6.51
|
| Rate for Payer: BCBS Trust/PPO |
$43.61
|
| Rate for Payer: BCN Commercial |
$41.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.51
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cofinity Commercial |
$50.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.51
|
| Rate for Payer: Healthscope Commercial |
$53.26
|
| Rate for Payer: Healthscope Whirlpool |
$51.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.51
|
| Rate for Payer: Mclaren Commercial |
$47.93
|
| Rate for Payer: Mclaren Medicaid |
$3.49
|
| Rate for Payer: Mclaren Medicare |
$6.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.84
|
| Rate for Payer: Meridian Medicaid |
$3.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.27
|
| Rate for Payer: Nomi Health Commercial |
$43.67
|
| Rate for Payer: PACE Medicare |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.51
|
| Rate for Payer: PHP Commercial |
$7.16
|
| Rate for Payer: PHP Medicaid |
$3.49
|
| Rate for Payer: PHP Medicare Advantage |
$6.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.06
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health Narrow Network |
$40.85
|
| Rate for Payer: Railroad Medicare Medicare |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.51
|
| Rate for Payer: UHC Exchange |
$10.09
|
| Rate for Payer: UHC Medicare Advantage |
$6.51
|
| Rate for Payer: UHCCP DNSP |
$6.51
|
| Rate for Payer: UHCCP Medicaid |
$3.49
|
| Rate for Payer: VA VA |
$6.51
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
IP
|
$412.29
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$267.99 |
| Max. Negotiated Rate |
$412.29 |
| Rate for Payer: Aetna Commercial |
$371.06
|
| Rate for Payer: ASR ASR |
$399.92
|
| Rate for Payer: ASR Commercial |
$399.92
|
| Rate for Payer: BCBS Trust/PPO |
$335.98
|
| Rate for Payer: BCN Commercial |
$319.65
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cofinity Commercial |
$387.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.83
|
| Rate for Payer: Healthscope Commercial |
$412.29
|
| Rate for Payer: Healthscope Whirlpool |
$399.92
|
| Rate for Payer: Mclaren Commercial |
$371.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.45
|
| Rate for Payer: Nomi Health Commercial |
$338.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.82
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
OP
|
$412.29
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$412.29 |
| Rate for Payer: Aetna Commercial |
$371.06
|
| Rate for Payer: Aetna Medicare |
$157.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.78
|
| Rate for Payer: ASR ASR |
$399.92
|
| Rate for Payer: ASR Commercial |
$399.92
|
| Rate for Payer: BCBS Complete |
$88.60
|
| Rate for Payer: BCBS MAPPO |
$157.42
|
| Rate for Payer: BCBS Trust/PPO |
$337.62
|
| Rate for Payer: BCN Commercial |
$319.65
|
| Rate for Payer: BCN Medicare Advantage |
$157.42
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cofinity Commercial |
$387.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$412.29
|
| Rate for Payer: Healthscope Whirlpool |
$399.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$157.42
|
| Rate for Payer: Mclaren Commercial |
$371.06
|
| Rate for Payer: Mclaren Medicaid |
$84.38
|
| Rate for Payer: Mclaren Medicare |
$157.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.29
|
| Rate for Payer: Meridian Medicaid |
$88.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.45
|
| Rate for Payer: Nomi Health Commercial |
$338.08
|
| Rate for Payer: PACE Medicare |
$149.55
|
| Rate for Payer: PACE SWMI |
$157.42
|
| Rate for Payer: PHP Commercial |
$173.16
|
| Rate for Payer: PHP Medicaid |
$84.38
|
| Rate for Payer: PHP Medicare Advantage |
$157.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$157.42
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$244.00
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP DNSP |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: VA VA |
$157.42
|
|
|
HC CPR
|
Facility
|
OP
|
$980.01
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$980.01 |
| Rate for Payer: Aetna Commercial |
$882.01
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$950.61
|
| Rate for Payer: ASR Commercial |
$950.61
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$802.53
|
| Rate for Payer: BCN Commercial |
$759.80
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cofinity Commercial |
$921.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$980.01
|
| Rate for Payer: Healthscope Whirlpool |
$950.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$882.01
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.01
|
| Rate for Payer: Nomi Health Commercial |
$803.61
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.75
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$329.40
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$862.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC CPR
|
Facility
|
IP
|
$980.01
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$637.01 |
| Max. Negotiated Rate |
$980.01 |
| Rate for Payer: Aetna Commercial |
$882.01
|
| Rate for Payer: ASR ASR |
$950.61
|
| Rate for Payer: ASR Commercial |
$950.61
|
| Rate for Payer: BCBS Trust/PPO |
$798.61
|
| Rate for Payer: BCN Commercial |
$759.80
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cofinity Commercial |
$921.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.01
|
| Rate for Payer: Healthscope Commercial |
$980.01
|
| Rate for Payer: Healthscope Whirlpool |
$950.61
|
| Rate for Payer: Mclaren Commercial |
$882.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.01
|
| Rate for Payer: Nomi Health Commercial |
$803.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$862.41
|
|
|
HC CRAB IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC CRAB IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
