|
HC CRE
|
Facility
|
IP
|
$1,453.22
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$944.59 |
| Max. Negotiated Rate |
$1,453.22 |
| Rate for Payer: Aetna Commercial |
$1,307.90
|
| Rate for Payer: ASR ASR |
$1,409.62
|
| Rate for Payer: ASR Commercial |
$1,409.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.23
|
| Rate for Payer: BCN Commercial |
$1,126.68
|
| Rate for Payer: Cash Price |
$1,162.58
|
| Rate for Payer: Cofinity Commercial |
$1,366.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,162.58
|
| Rate for Payer: Healthscope Commercial |
$1,453.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,409.62
|
| Rate for Payer: Mclaren Commercial |
$1,307.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,235.24
|
| Rate for Payer: Nomi Health Commercial |
$1,191.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$944.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,278.83
|
|
|
HC CRE
|
Facility
|
OP
|
$1,453.22
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$581.29 |
| Max. Negotiated Rate |
$1,453.22 |
| Rate for Payer: Aetna Commercial |
$1,307.90
|
| Rate for Payer: Aetna Medicare |
$726.61
|
| Rate for Payer: ASR ASR |
$1,409.62
|
| Rate for Payer: ASR Commercial |
$1,409.62
|
| Rate for Payer: BCBS Complete |
$581.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.04
|
| Rate for Payer: BCN Commercial |
$1,126.68
|
| Rate for Payer: Cash Price |
$1,162.58
|
| Rate for Payer: Cofinity Commercial |
$1,366.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,162.58
|
| Rate for Payer: Healthscope Commercial |
$1,453.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,409.62
|
| Rate for Payer: Mclaren Commercial |
$1,307.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,235.24
|
| Rate for Payer: Nomi Health Commercial |
$1,191.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$944.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,018.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,278.83
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
IP
|
$61.61
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.05 |
| Max. Negotiated Rate |
$61.61 |
| Rate for Payer: Aetna Commercial |
$55.45
|
| Rate for Payer: ASR ASR |
$59.76
|
| Rate for Payer: ASR Commercial |
$59.76
|
| Rate for Payer: BCBS Trust/PPO |
$50.21
|
| Rate for Payer: BCN Commercial |
$47.77
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$57.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Healthscope Commercial |
$61.61
|
| Rate for Payer: Healthscope Whirlpool |
$59.76
|
| Rate for Payer: Mclaren Commercial |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.22
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
OP
|
$61.61
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$61.61 |
| Rate for Payer: Aetna Commercial |
$55.45
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$59.76
|
| Rate for Payer: ASR Commercial |
$59.76
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$50.45
|
| Rate for Payer: BCN Commercial |
$47.77
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$57.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$61.61
|
| Rate for Payer: Healthscope Whirlpool |
$59.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$55.45
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.15
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$41.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
OP
|
$5,158.30
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,980.39 |
| Max. Negotiated Rate |
$5,726.86 |
| Rate for Payer: Aetna Commercial |
$4,642.47
|
| Rate for Payer: Aetna Medicare |
$3,694.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,618.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,618.44
|
| Rate for Payer: ASR ASR |
$5,003.55
|
| Rate for Payer: ASR Commercial |
$5,003.55
|
| Rate for Payer: BCBS Complete |
$2,079.41
|
| Rate for Payer: BCBS MAPPO |
$3,694.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,224.13
|
| Rate for Payer: BCN Commercial |
$3,999.23
|
| Rate for Payer: BCN Medicare Advantage |
$3,694.75
|
| Rate for Payer: Cash Price |
$4,126.64
|
| Rate for Payer: Cash Price |
$4,126.64
|
| Rate for Payer: Cofinity Commercial |
$4,848.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,126.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,694.75
|
| Rate for Payer: Healthscope Commercial |
$5,158.30
|
| Rate for Payer: Healthscope Whirlpool |
$5,003.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,694.75
|
| Rate for Payer: Mclaren Commercial |
$4,642.47
|
| Rate for Payer: Mclaren Medicaid |
$1,980.39
|
| Rate for Payer: Mclaren Medicare |
$3,694.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,879.49
|
| Rate for Payer: Meridian Medicaid |
$2,079.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,248.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,384.56
|
| Rate for Payer: Nomi Health Commercial |
$4,229.81
|
| Rate for Payer: PACE Medicare |
$3,510.01
|
| Rate for Payer: PACE SWMI |
$3,694.75
|
| Rate for Payer: PHP Commercial |
$4,064.22
|
| Rate for Payer: PHP Medicaid |
$1,980.39
|
| Rate for Payer: PHP Medicare Advantage |
$3,694.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,980.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,352.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,519.70
|
| Rate for Payer: Priority Health Medicare |
$3,694.75
|
| Rate for Payer: Priority Health Narrow Network |
$3,615.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,694.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,539.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,694.75
|
| Rate for Payer: UHC Exchange |
$5,726.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,694.75
|
| Rate for Payer: UHCCP DNSP |
$3,694.75
|
| Rate for Payer: UHCCP Medicaid |
$1,980.39
|
| Rate for Payer: VA VA |
$3,694.75
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
IP
|
$5,158.30
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,352.90 |
| Max. Negotiated Rate |
$5,158.30 |
| Rate for Payer: Aetna Commercial |
$4,642.47
|
| Rate for Payer: ASR ASR |
$5,003.55
|
| Rate for Payer: ASR Commercial |
$5,003.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,203.50
|
| Rate for Payer: BCN Commercial |
$3,999.23
|
| Rate for Payer: Cash Price |
$4,126.64
|
| Rate for Payer: Cofinity Commercial |
$4,848.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,126.64
|
| Rate for Payer: Healthscope Commercial |
$5,158.30
|
| Rate for Payer: Healthscope Whirlpool |
$5,003.55
|
| Rate for Payer: Mclaren Commercial |
$4,642.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,384.56
|
| Rate for Payer: Nomi Health Commercial |
$4,229.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,352.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,539.30
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.67
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare |
$9.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.82
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Complete |
$5.32
|
| Rate for Payer: BCBS MAPPO |
$9.46
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: BCN Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.46
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Mclaren Medicare |
$9.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.93
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Medicare |
$8.99
|
| Rate for Payer: PACE SWMI |
$9.46
|
| Rate for Payer: PHP Commercial |
$10.41
|
| Rate for Payer: PHP Medicaid |
$5.07
|
| Rate for Payer: PHP Medicare Advantage |
$9.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.93
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow Network |
$26.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.46
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: UHCCP DNSP |
$9.46
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: VA VA |
$9.46
|
|
|
HC CREATININE SERUM
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| 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 CREATININE SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$24.71 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| 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 |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.12
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.74
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$5.63
|
| Rate for Payer: PHP Medicaid |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.71
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health Narrow Network |
$19.77
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.94
|
| Rate for Payer: UHC Medicare Advantage |
$5.12
|
| Rate for Payer: UHCCP DNSP |
$5.12
|
| Rate for Payer: UHCCP Medicaid |
$2.74
|
| Rate for Payer: VA VA |
$5.12
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$31.50
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$137.25 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.25
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$109.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.26 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: ASR Commercial |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$16.62
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: Nomi Health Commercial |
$16.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$24.71 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: ASR Commercial |
$19.79
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCBS Trust/PPO |
$16.71
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.12
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$2.74
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: Nomi Health Commercial |
$16.73
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$5.63
|
| Rate for Payer: PHP Medicaid |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.71
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health Narrow Network |
$19.77
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.94
|
| Rate for Payer: UHC Medicare Advantage |
$5.12
|
| Rate for Payer: UHCCP DNSP |
$5.12
|
| Rate for Payer: UHCCP Medicaid |
$2.74
|
| Rate for Payer: VA VA |
$5.12
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
IP
|
$39.99
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$39.99 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: ASR ASR |
$38.79
|
| Rate for Payer: ASR Commercial |
$38.79
|
| Rate for Payer: BCBS Trust/PPO |
$32.59
|
| Rate for Payer: BCN Commercial |
$31.00
|
| Rate for Payer: Cash Price |
$31.99
|
| Rate for Payer: Cofinity Commercial |
$37.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.99
|
| Rate for Payer: Healthscope Commercial |
$39.99
|
| Rate for Payer: Healthscope Whirlpool |
$38.79
|
| Rate for Payer: Mclaren Commercial |
$35.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.99
|
| Rate for Payer: Nomi Health Commercial |
$32.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.19
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
OP
|
$39.99
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$39.99 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: ASR ASR |
$38.79
|
| Rate for Payer: ASR Commercial |
$38.79
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$32.75
|
| Rate for Payer: BCN Commercial |
$31.00
|
| Rate for Payer: Cash Price |
$31.99
|
| Rate for Payer: Cofinity Commercial |
$37.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.99
|
| Rate for Payer: Healthscope Commercial |
$39.99
|
| Rate for Payer: Healthscope Whirlpool |
$38.79
|
| Rate for Payer: Mclaren Commercial |
$35.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.99
|
| Rate for Payer: Nomi Health Commercial |
$32.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.04
|
| Rate for Payer: Priority Health Narrow Network |
$28.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.19
|
|
|
HC CRITICAL CARE R&B
|
Facility
|
IP
|
$6,337.46
|
|
| Hospital Charge Code |
20000001
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$4,119.35 |
| Max. Negotiated Rate |
$6,337.46 |
| Rate for Payer: Aetna Commercial |
$5,703.71
|
| Rate for Payer: ASR ASR |
$6,147.34
|
| Rate for Payer: ASR Commercial |
$6,147.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,164.40
|
| Rate for Payer: BCN Commercial |
$4,913.43
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cofinity Commercial |
$5,957.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,069.97
|
| Rate for Payer: Healthscope Commercial |
$6,337.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,147.34
|
| Rate for Payer: Mclaren Commercial |
$5,703.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,386.84
|
| Rate for Payer: Nomi Health Commercial |
$5,196.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,576.96
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
OP
|
$160.14
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$160.14 |
| Rate for Payer: Aetna Commercial |
$144.13
|
| Rate for Payer: Aetna Medicare |
$29.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: ASR ASR |
$155.34
|
| Rate for Payer: ASR Commercial |
$155.34
|
| Rate for Payer: BCBS Complete |
$16.44
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCBS Trust/PPO |
$131.14
|
| Rate for Payer: BCN Commercial |
$124.16
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$128.11
|
| Rate for Payer: Cash Price |
$128.11
|
| Rate for Payer: Cofinity Commercial |
$150.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$160.14
|
| Rate for Payer: Healthscope Whirlpool |
$155.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.21
|
| Rate for Payer: Mclaren Commercial |
$144.13
|
| Rate for Payer: Mclaren Medicaid |
$15.66
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$16.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.12
|
| Rate for Payer: Nomi Health Commercial |
$131.31
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$32.13
|
| Rate for Payer: PHP Medicaid |
$15.66
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.31
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Narrow Network |
$112.26
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.21
|
| Rate for Payer: UHC Exchange |
$45.28
|
| Rate for Payer: UHC Medicare Advantage |
$29.21
|
| Rate for Payer: UHCCP DNSP |
$29.21
|
| Rate for Payer: UHCCP Medicaid |
$15.66
|
| Rate for Payer: VA VA |
$29.21
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
IP
|
$160.14
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.09 |
| Max. Negotiated Rate |
$160.14 |
| Rate for Payer: Aetna Commercial |
$144.13
|
| Rate for Payer: ASR ASR |
$155.34
|
| Rate for Payer: ASR Commercial |
$155.34
|
| Rate for Payer: BCBS Trust/PPO |
$130.50
|
| Rate for Payer: BCN Commercial |
$124.16
|
| Rate for Payer: Cash Price |
$128.11
|
| Rate for Payer: Cofinity Commercial |
$150.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.11
|
| Rate for Payer: Healthscope Commercial |
$160.14
|
| Rate for Payer: Healthscope Whirlpool |
$155.34
|
| Rate for Payer: Mclaren Commercial |
$144.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.12
|
| Rate for Payer: Nomi Health Commercial |
$131.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.92
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
IP
|
$158.10
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$102.76 |
| Max. Negotiated Rate |
$158.10 |
| Rate for Payer: Aetna Commercial |
$142.29
|
| Rate for Payer: ASR ASR |
$153.36
|
| Rate for Payer: ASR Commercial |
$153.36
|
| Rate for Payer: BCBS Trust/PPO |
$128.84
|
| Rate for Payer: BCN Commercial |
$122.57
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$148.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.48
|
| Rate for Payer: Healthscope Commercial |
$158.10
|
| Rate for Payer: Healthscope Whirlpool |
$153.36
|
| Rate for Payer: Mclaren Commercial |
$142.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.38
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.13
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
OP
|
$158.10
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$193.25 |
| Rate for Payer: Aetna Commercial |
$142.29
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$153.36
|
| Rate for Payer: ASR Commercial |
$153.36
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$129.47
|
| Rate for Payer: BCN Commercial |
$122.57
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$148.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$158.10
|
| Rate for Payer: Healthscope Whirlpool |
$153.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$142.29
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.38
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.25
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$154.60
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
IP
|
$184.62
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$184.62 |
| Rate for Payer: Aetna Commercial |
$166.16
|
| Rate for Payer: ASR ASR |
$179.08
|
| Rate for Payer: ASR Commercial |
$179.08
|
| Rate for Payer: BCBS Trust/PPO |
$150.45
|
| Rate for Payer: BCN Commercial |
$143.14
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: Cofinity Commercial |
$173.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.70
|
| Rate for Payer: Healthscope Commercial |
$184.62
|
| Rate for Payer: Healthscope Whirlpool |
$179.08
|
| Rate for Payer: Mclaren Commercial |
$166.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.93
|
| Rate for Payer: Nomi Health Commercial |
$151.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.47
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
OP
|
$184.62
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.36 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$166.16
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$179.08
|
| Rate for Payer: ASR Commercial |
$179.08
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$151.19
|
| Rate for Payer: BCN Commercial |
$143.14
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: Cofinity Commercial |
$173.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$184.62
|
| Rate for Payer: Healthscope Whirlpool |
$179.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$166.16
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.93
|
| Rate for Payer: Nomi Health Commercial |
$151.39
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.45
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$44.36
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$51.12
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.69
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$43.76
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$50.87
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
|
