|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$23.14 |
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: Aetna Medicare |
$14.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.68
|
| Rate for Payer: ASR ASR |
$22.45
|
| Rate for Payer: ASR Commercial |
$22.45
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: BCBS MAPPO |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$18.95
|
| Rate for Payer: BCN Commercial |
$17.94
|
| Rate for Payer: BCN Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$23.14
|
| Rate for Payer: Healthscope Whirlpool |
$22.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.14
|
| Rate for Payer: Mclaren Commercial |
$20.83
|
| Rate for Payer: Mclaren Medicaid |
$7.58
|
| Rate for Payer: Mclaren Medicare |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.85
|
| Rate for Payer: Meridian Medicaid |
$7.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: Nomi Health Commercial |
$18.97
|
| Rate for Payer: PACE Medicare |
$13.43
|
| Rate for Payer: PACE SWMI |
$14.14
|
| Rate for Payer: PHP Commercial |
$15.55
|
| Rate for Payer: PHP Medicaid |
$7.58
|
| Rate for Payer: PHP Medicare Advantage |
$14.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.28
|
| Rate for Payer: Priority Health Medicare |
$14.14
|
| Rate for Payer: Priority Health Narrow Network |
$16.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.14
|
| Rate for Payer: UHC Exchange |
$21.92
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: UHCCP DNSP |
$14.14
|
| Rate for Payer: UHCCP Medicaid |
$7.58
|
| Rate for Payer: VA VA |
$14.14
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.51 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: ASR Commercial |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$35.74
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: ASR Commercial |
$42.54
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$35.92
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.43
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$30.75
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$143.16 |
| Rate for Payer: Aetna Commercial |
$128.84
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$138.87
|
| Rate for Payer: ASR Commercial |
$138.87
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$117.23
|
| Rate for Payer: BCN Commercial |
$110.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$134.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$143.16
|
| Rate for Payer: Healthscope Whirlpool |
$138.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$128.84
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$117.39
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.44
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$100.36
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$93.05 |
| Max. Negotiated Rate |
$143.16 |
| Rate for Payer: Aetna Commercial |
$128.84
|
| Rate for Payer: ASR ASR |
$138.87
|
| Rate for Payer: ASR Commercial |
$138.87
|
| Rate for Payer: BCBS Trust/PPO |
$116.66
|
| Rate for Payer: BCN Commercial |
$110.99
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$134.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Healthscope Commercial |
$143.16
|
| Rate for Payer: Healthscope Whirlpool |
$138.87
|
| Rate for Payer: Mclaren Commercial |
$128.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$117.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.98
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$221.51 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$306.70
|
| Rate for Payer: ASR ASR |
$330.56
|
| Rate for Payer: ASR Commercial |
$330.56
|
| Rate for Payer: BCBS Trust/PPO |
$277.70
|
| Rate for Payer: BCN Commercial |
$264.21
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Healthscope Whirlpool |
$330.56
|
| Rate for Payer: Mclaren Commercial |
$306.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$279.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.89
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$306.70
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$330.56
|
| Rate for Payer: ASR Commercial |
$330.56
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$279.06
|
| Rate for Payer: BCN Commercial |
$264.21
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Healthscope Whirlpool |
$330.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$306.70
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$279.44
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.59
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$238.89
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.00
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$174.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.00
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$174.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.00
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$174.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.00
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$174.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.00
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Mclaren Medicare |
$62.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$68.20
|
| Rate for Payer: PHP Medicaid |
$33.23
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.00
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$174.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Exchange |
$96.10
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP DNSP |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: VA VA |
$62.00
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$553.35
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$553.35 |
| Rate for Payer: Aetna Commercial |
$498.01
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$536.75
|
| Rate for Payer: ASR Commercial |
$536.75
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$453.14
|
| Rate for Payer: BCN Commercial |
$429.01
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cofinity Commercial |
$520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$553.35
|
| Rate for Payer: Healthscope Whirlpool |
$536.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$498.01
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.35
|
| Rate for Payer: Nomi Health Commercial |
$453.75
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.85
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$387.90
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$486.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$553.35
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$359.68 |
| Max. Negotiated Rate |
$553.35 |
| Rate for Payer: Aetna Commercial |
$498.01
|
| Rate for Payer: ASR ASR |
$536.75
|
| Rate for Payer: ASR Commercial |
$536.75
|
| Rate for Payer: BCBS Trust/PPO |
$450.92
|
| Rate for Payer: BCN Commercial |
$429.01
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cofinity Commercial |
$520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.68
|
| Rate for Payer: Healthscope Commercial |
$553.35
|
| Rate for Payer: Healthscope Whirlpool |
$536.75
|
| Rate for Payer: Mclaren Commercial |
$498.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.35
|
| Rate for Payer: Nomi Health Commercial |
$453.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$486.95
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$38.34
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.02
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$32.82
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.15
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$13.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.27
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Complete |
$7.78
|
| Rate for Payer: BCBS MAPPO |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: BCN Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.82
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$7.41
|
| Rate for Payer: Mclaren Medicare |
$13.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.51
|
| Rate for Payer: Meridian Medicaid |
$7.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Medicare |
$13.13
|
| Rate for Payer: PACE SWMI |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.20
|
| Rate for Payer: PHP Medicaid |
$7.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Medicare |
$13.82
|
| Rate for Payer: Priority Health Narrow Network |
$32.09
|
| Rate for Payer: Railroad Medicare Medicare |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.82
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$13.82
|
| Rate for Payer: UHCCP DNSP |
$13.82
|
| Rate for Payer: UHCCP Medicaid |
$7.41
|
| Rate for Payer: VA VA |
$13.82
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.31
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
