|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$51.40
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.90
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: BCBS Complete |
$7.77
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$51.40
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.52
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$7.40
|
| Rate for Payer: Mclaren Medicare |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$7.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Medicare |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$14.87
|
| Rate for Payer: PHP Medicaid |
$7.40
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.33
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow Network |
$47.07
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Medicare Advantage |
$13.93
|
| Rate for Payer: VA VA |
$13.52
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: Aetna Medicare |
$19.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: ASR ASR |
$72.75
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$75.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.35
|
| Rate for Payer: Mclaren Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$10.58
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Medicaid |
$11.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$21.28
|
| Rate for Payer: PHP Medicaid |
$10.58
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$53.25
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.00
|
| Rate for Payer: UHC Medicare Advantage |
$19.93
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: ASR ASR |
$72.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$75.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.75
|
| Rate for Payer: Mclaren Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.00
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$260.84
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$182.59 |
| Max. Negotiated Rate |
$260.84 |
| Rate for Payer: Aetna Commercial |
$234.76
|
| Rate for Payer: ASR ASR |
$253.01
|
| Rate for Payer: BCBS Trust/PPO |
$202.23
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: Cash Price |
$208.67
|
| Rate for Payer: Cofinity Commercial |
$245.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.67
|
| Rate for Payer: Healthscope Commercial |
$260.84
|
| Rate for Payer: Healthscope Whirlpool |
$253.01
|
| Rate for Payer: Mclaren Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.54
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$260.84
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$92.94 |
| Max. Negotiated Rate |
$260.84 |
| Rate for Payer: Aetna Commercial |
$234.76
|
| Rate for Payer: Aetna Medicare |
$169.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.38
|
| Rate for Payer: ASR ASR |
$253.01
|
| Rate for Payer: BCBS Complete |
$97.59
|
| Rate for Payer: BCBS MAPPO |
$169.90
|
| Rate for Payer: BCBS Trust/PPO |
$202.23
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: BCN Medicare Advantage |
$169.90
|
| Rate for Payer: Cash Price |
$208.67
|
| Rate for Payer: Cash Price |
$208.67
|
| Rate for Payer: Cofinity Commercial |
$245.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.90
|
| Rate for Payer: Healthscope Commercial |
$260.84
|
| Rate for Payer: Healthscope Whirlpool |
$253.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$169.90
|
| Rate for Payer: Mclaren Commercial |
$234.76
|
| Rate for Payer: Mclaren Medicaid |
$92.94
|
| Rate for Payer: Mclaren Medicare |
$169.90
|
| Rate for Payer: Meridian Medicaid |
$97.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.71
|
| Rate for Payer: PACE Medicare |
$161.40
|
| Rate for Payer: PACE SWMI |
$169.90
|
| Rate for Payer: PHP Commercial |
$186.89
|
| Rate for Payer: PHP Medicaid |
$92.94
|
| Rate for Payer: PHP Medicare Advantage |
$169.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.41
|
| Rate for Payer: Priority Health Medicare |
$169.90
|
| Rate for Payer: Priority Health Narrow Network |
$127.53
|
| Rate for Payer: Railroad Medicare Medicare |
$169.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.54
|
| Rate for Payer: UHC Medicare Advantage |
$175.00
|
| Rate for Payer: VA VA |
$169.90
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: BCBS Trust/PPO |
$37.96
|
| Rate for Payer: BCN Commercial |
$37.96
|
| 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: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: BCBS Complete |
$14.83
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$37.96
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| 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 |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.81
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Mclaren Medicaid |
$14.12
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Medicaid |
$14.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$28.39
|
| Rate for Payer: PHP Medicaid |
$14.12
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.46
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$77.17
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Medicare Advantage |
$26.58
|
| Rate for Payer: VA VA |
$25.81
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,702.70
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$367.76 |
| Max. Negotiated Rate |
$2,702.70 |
| Rate for Payer: Aetna Commercial |
$2,432.43
|
| Rate for Payer: Aetna Medicare |
$672.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$840.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$840.41
|
| Rate for Payer: ASR ASR |
$2,621.62
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$672.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,095.40
|
| Rate for Payer: BCN Commercial |
$2,095.40
|
| Rate for Payer: BCN Medicare Advantage |
$672.33
|
| Rate for Payer: Cash Price |
$2,162.16
|
| Rate for Payer: Cash Price |
$2,162.16
|
| Rate for Payer: Cofinity Commercial |
$2,540.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,162.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.33
|
| Rate for Payer: Healthscope Commercial |
$2,702.70
|
| Rate for Payer: Healthscope Whirlpool |
$2,621.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$672.33
|
| Rate for Payer: Mclaren Commercial |
$2,432.43
|
| Rate for Payer: Mclaren Medicaid |
$367.76
|
| Rate for Payer: Mclaren Medicare |
$672.33
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$705.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$773.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,297.30
|
| Rate for Payer: PACE Medicare |
$638.71
|
| Rate for Payer: PACE SWMI |
$672.33
|
| Rate for Payer: PHP Commercial |
$739.56
|
| Rate for Payer: PHP Medicaid |
$367.76
|
| Rate for Payer: PHP Medicare Advantage |
$672.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,459.46
|
| Rate for Payer: Priority Health Medicare |
$672.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,918.92
|
| Rate for Payer: Railroad Medicare Medicare |
$672.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,378.38
|
| Rate for Payer: UHC Medicare Advantage |
$692.50
|
| Rate for Payer: VA VA |
$672.33
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,702.70
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,891.89 |
| Max. Negotiated Rate |
$2,702.70 |
| Rate for Payer: Aetna Commercial |
$2,432.43
|
| Rate for Payer: ASR ASR |
$2,621.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,095.40
|
| Rate for Payer: BCN Commercial |
$2,095.40
|
| Rate for Payer: Cash Price |
$2,162.16
|
| Rate for Payer: Cofinity Commercial |
$2,540.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,162.16
|
| Rate for Payer: Healthscope Commercial |
$2,702.70
|
| Rate for Payer: Healthscope Whirlpool |
$2,621.62
|
| Rate for Payer: Mclaren Commercial |
$2,432.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,297.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,378.38
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$652.67
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$456.87 |
| Max. Negotiated Rate |
$652.67 |
| Rate for Payer: Aetna Commercial |
$587.40
|
| Rate for Payer: ASR ASR |
$633.09
|
| Rate for Payer: BCBS Trust/PPO |
$506.02
|
| Rate for Payer: BCN Commercial |
$506.02
|
| Rate for Payer: Cash Price |
$522.14
|
| Rate for Payer: Cofinity Commercial |
$613.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.14
|
| Rate for Payer: Healthscope Commercial |
$652.67
|
| Rate for Payer: Healthscope Whirlpool |
$633.09
|
| Rate for Payer: Mclaren Commercial |
$587.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$554.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$574.35
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$652.67
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$652.67 |
| Rate for Payer: Aetna Commercial |
$587.40
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$633.09
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$506.02
|
| Rate for Payer: BCN Commercial |
$506.02
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$522.14
|
| Rate for Payer: Cash Price |
$522.14
|
| Rate for Payer: Cofinity Commercial |
$613.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$652.67
|
| Rate for Payer: Healthscope Whirlpool |
$633.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$587.40
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$554.77
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.00
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$574.35
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,033.01
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$723.11 |
| Max. Negotiated Rate |
$1,033.01 |
| Rate for Payer: Aetna Commercial |
$929.71
|
| Rate for Payer: ASR ASR |
$1,002.02
|
| Rate for Payer: BCBS Trust/PPO |
$800.89
|
| Rate for Payer: BCN Commercial |
$800.89
|
| Rate for Payer: Cash Price |
$826.41
|
| Rate for Payer: Cofinity Commercial |
$971.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.41
|
| Rate for Payer: Healthscope Commercial |
$1,033.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.02
|
| Rate for Payer: Mclaren Commercial |
$929.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.05
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,033.01
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$1,033.01 |
| Rate for Payer: Aetna Commercial |
$929.71
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$1,002.02
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$800.89
|
| Rate for Payer: BCN Commercial |
$800.89
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$826.41
|
| Rate for Payer: Cash Price |
$826.41
|
| Rate for Payer: Cofinity Commercial |
$971.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$1,033.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$929.71
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.06
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.00
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.05
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$208.01 |
| Rate for Payer: Aetna Commercial |
$187.21
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$201.77
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$161.27
|
| Rate for Payer: BCN Commercial |
$161.27
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$195.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$208.01
|
| Rate for Payer: Healthscope Whirlpool |
$201.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$187.21
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.29
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$147.69
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.05
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$145.61 |
| Max. Negotiated Rate |
$208.01 |
| Rate for Payer: Aetna Commercial |
$187.21
|
| Rate for Payer: ASR ASR |
$201.77
|
| Rate for Payer: BCBS Trust/PPO |
$161.27
|
| Rate for Payer: BCN Commercial |
$161.27
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$195.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Healthscope Commercial |
$208.01
|
| Rate for Payer: Healthscope Whirlpool |
$201.77
|
| Rate for Payer: Mclaren Commercial |
$187.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.05
|
|
|
HC HOME SLEEP TEST/TYPE 4 PORTA
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
HCPCS G0400
|
| Hospital Charge Code |
92000028
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$145.61 |
| Max. Negotiated Rate |
$208.01 |
| Rate for Payer: Aetna Commercial |
$187.21
|
| Rate for Payer: ASR ASR |
$201.77
|
| Rate for Payer: BCBS Trust/PPO |
$161.27
|
| Rate for Payer: BCN Commercial |
$161.27
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$195.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Healthscope Commercial |
$208.01
|
| Rate for Payer: Healthscope Whirlpool |
$201.77
|
| Rate for Payer: Mclaren Commercial |
$187.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.05
|
|
|
HC HOME SLEEP TEST/TYPE 4 PORTA
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
HCPCS G0400
|
| Hospital Charge Code |
92000028
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$145.61 |
| Max. Negotiated Rate |
$348.75 |
| Rate for Payer: Aetna Commercial |
$187.21
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$201.77
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.27
|
| Rate for Payer: BCN Commercial |
$161.27
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$195.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$208.01
|
| Rate for Payer: Healthscope Whirlpool |
$201.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$187.21
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.29
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$147.69
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.05
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC HOMOCYSTEINE SERUM
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
30100243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$138.53 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$17.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$17.92
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$17.92
|
| 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 |
$17.92
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.92
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Mclaren Medicare |
$17.92
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$17.02
|
| Rate for Payer: PACE SWMI |
$17.92
|
| Rate for Payer: PHP Commercial |
$19.71
|
| Rate for Payer: PHP Medicaid |
$9.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.53
|
| Rate for Payer: Priority Health Medicare |
$17.92
|
| Rate for Payer: Priority Health Narrow Network |
$110.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$18.46
|
| Rate for Payer: VA VA |
$17.92
|
|
|
HC HOMOCYSTEINE SERUM
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
30100243
|
|
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 HOMOVANILLIC ACID RANDOM URINE
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100474
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: BCBS Complete |
$12.87
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$48.24
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.41
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$12.26
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Medicaid |
$12.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Medicaid |
$12.26
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.62
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.18
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Medicare Advantage |
$23.08
|
| Rate for Payer: VA VA |
$22.41
|
|
|
HC HOMOVANILLIC ACID RANDOM URINE
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100474
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$48.24
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC HOMOVANILLIC ACID URINE
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$48.24
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC HOMOVANILLIC ACID URINE
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: BCBS Complete |
$12.87
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$48.24
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.41
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$12.26
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Medicaid |
$12.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Medicaid |
$12.26
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.62
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.18
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Medicare Advantage |
$23.08
|
| Rate for Payer: VA VA |
$22.41
|
|
|
HC HONEY BEE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200089
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| 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 |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
