|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.30 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: ASR ASR |
$37.83
|
| Rate for Payer: BCBS Trust/PPO |
$30.24
|
| Rate for Payer: BCN Commercial |
$30.24
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$39.00
|
| Rate for Payer: Healthscope Whirlpool |
$37.83
|
| Rate for Payer: Mclaren Commercial |
$35.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.32
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
OP
|
$62.02
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$62.02 |
| Rate for Payer: Aetna Commercial |
$55.82
|
| Rate for Payer: Aetna Medicare |
$16.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.58
|
| Rate for Payer: ASR ASR |
$60.16
|
| Rate for Payer: BCBS Complete |
$9.45
|
| Rate for Payer: BCBS MAPPO |
$16.46
|
| Rate for Payer: BCBS Trust/PPO |
$48.08
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: BCN Medicare Advantage |
$16.46
|
| Rate for Payer: Cash Price |
$49.62
|
| Rate for Payer: Cash Price |
$49.62
|
| Rate for Payer: Cofinity Commercial |
$58.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.46
|
| Rate for Payer: Healthscope Commercial |
$62.02
|
| Rate for Payer: Healthscope Whirlpool |
$60.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.46
|
| Rate for Payer: Mclaren Commercial |
$55.82
|
| Rate for Payer: Mclaren Medicaid |
$9.00
|
| Rate for Payer: Mclaren Medicare |
$16.46
|
| Rate for Payer: Meridian Medicaid |
$9.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.72
|
| Rate for Payer: PACE Medicare |
$15.64
|
| Rate for Payer: PACE SWMI |
$16.46
|
| Rate for Payer: PHP Commercial |
$18.11
|
| Rate for Payer: PHP Medicaid |
$9.00
|
| Rate for Payer: PHP Medicare Advantage |
$16.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.21
|
| Rate for Payer: Priority Health Medicare |
$16.46
|
| Rate for Payer: Priority Health Narrow Network |
$37.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.58
|
| Rate for Payer: UHC Medicare Advantage |
$16.95
|
| Rate for Payer: VA VA |
$16.46
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
IP
|
$62.02
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.41 |
| Max. Negotiated Rate |
$62.02 |
| Rate for Payer: Aetna Commercial |
$55.82
|
| Rate for Payer: ASR ASR |
$60.16
|
| Rate for Payer: BCBS Trust/PPO |
$48.08
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.62
|
| Rate for Payer: Cofinity Commercial |
$58.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.62
|
| Rate for Payer: Healthscope Commercial |
$62.02
|
| Rate for Payer: Healthscope Whirlpool |
$60.16
|
| Rate for Payer: Mclaren Commercial |
$55.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.58
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Aetna Medicare |
$9.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.30
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Mclaren Medicaid |
$5.09
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$5.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$10.23
|
| Rate for Payer: PHP Medicaid |
$5.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
| Rate for Payer: UHC Medicare Advantage |
$9.58
|
| Rate for Payer: VA VA |
$9.30
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.78 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Aetna Medicare |
$9.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.30
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Mclaren Medicaid |
$5.09
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$5.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$10.23
|
| Rate for Payer: PHP Medicaid |
$5.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
| Rate for Payer: UHC Medicare Advantage |
$9.58
|
| Rate for Payer: VA VA |
$9.30
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.78 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$49.25 |
| Rate for Payer: Aetna Commercial |
$20.20
|
| Rate for Payer: Aetna Medicare |
$9.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: ASR ASR |
$21.77
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$21.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$22.44
|
| Rate for Payer: Healthscope Whirlpool |
$21.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.30
|
| Rate for Payer: Mclaren Commercial |
$20.20
|
| Rate for Payer: Mclaren Medicaid |
$5.09
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$5.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$10.23
|
| Rate for Payer: PHP Medicaid |
$5.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$9.58
|
| Rate for Payer: VA VA |
$9.30
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Aetna Commercial |
$20.20
|
| Rate for Payer: ASR ASR |
$21.77
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$21.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$22.44
|
| Rate for Payer: Healthscope Whirlpool |
$21.77
|
| Rate for Payer: Mclaren Commercial |
$20.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.75
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
OP
|
$150.27
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.11 |
| Max. Negotiated Rate |
$150.27 |
| Rate for Payer: Aetna Commercial |
$135.24
|
| Rate for Payer: ASR ASR |
$145.76
|
| Rate for Payer: BCBS Complete |
$60.11
|
| Rate for Payer: BCBS Trust/PPO |
$116.50
|
| Rate for Payer: BCCCP Commercial |
$86.77
|
| Rate for Payer: BCN Commercial |
$116.50
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$141.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$150.27
|
| Rate for Payer: Healthscope Whirlpool |
$145.76
|
| Rate for Payer: Mclaren Commercial |
$135.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.75
|
| Rate for Payer: Priority Health Narrow Network |
$106.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.24
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
IP
|
$150.27
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$105.19 |
| Max. Negotiated Rate |
$150.27 |
| Rate for Payer: Aetna Commercial |
$135.24
|
| Rate for Payer: ASR ASR |
$145.76
|
| Rate for Payer: BCBS Trust/PPO |
$116.50
|
| Rate for Payer: BCN Commercial |
$116.50
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$141.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$150.27
|
| Rate for Payer: Healthscope Whirlpool |
$145.76
|
| Rate for Payer: Mclaren Commercial |
$135.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.24
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$170.02
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$119.01 |
| Max. Negotiated Rate |
$170.02 |
| Rate for Payer: Aetna Commercial |
$153.02
|
| Rate for Payer: ASR ASR |
$164.92
|
| Rate for Payer: BCBS Trust/PPO |
$131.82
|
| Rate for Payer: BCN Commercial |
$131.82
|
| Rate for Payer: Cash Price |
$136.02
|
| Rate for Payer: Cofinity Commercial |
$159.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.02
|
| Rate for Payer: Healthscope Commercial |
$170.02
|
| Rate for Payer: Healthscope Whirlpool |
$164.92
|
| Rate for Payer: Mclaren Commercial |
$153.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.62
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$170.02
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$83.05 |
| Max. Negotiated Rate |
$189.78 |
| Rate for Payer: Aetna Commercial |
$153.02
|
| Rate for Payer: Aetna Medicare |
$151.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: ASR ASR |
$164.92
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$131.82
|
| Rate for Payer: BCCCP Commercial |
$100.83
|
| Rate for Payer: BCN Commercial |
$131.82
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$136.02
|
| Rate for Payer: Cash Price |
$136.02
|
| Rate for Payer: Cofinity Commercial |
$159.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$170.02
|
| Rate for Payer: Healthscope Whirlpool |
$164.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.82
|
| Rate for Payer: Mclaren Commercial |
$153.02
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.52
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$167.00
|
| Rate for Payer: PHP Medicaid |
$83.05
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.37
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$137.10
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.62
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: VA VA |
$151.82
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$333.42
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.77 |
| Max. Negotiated Rate |
$399.39 |
| Rate for Payer: Aetna Commercial |
$300.08
|
| Rate for Payer: Aetna Medicare |
$319.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: ASR ASR |
$323.42
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$258.50
|
| Rate for Payer: BCN Commercial |
$258.50
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$266.74
|
| Rate for Payer: Cash Price |
$266.74
|
| Rate for Payer: Cofinity Commercial |
$313.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$333.42
|
| Rate for Payer: Healthscope Whirlpool |
$323.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$319.51
|
| Rate for Payer: Mclaren Commercial |
$300.08
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.41
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$351.46
|
| Rate for Payer: PHP Medicaid |
$174.77
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.41
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$236.73
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.41
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: VA VA |
$319.51
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
IP
|
$333.42
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$233.39 |
| Max. Negotiated Rate |
$333.42 |
| Rate for Payer: Aetna Commercial |
$300.08
|
| Rate for Payer: ASR ASR |
$323.42
|
| Rate for Payer: BCBS Trust/PPO |
$258.50
|
| Rate for Payer: BCN Commercial |
$258.50
|
| Rate for Payer: Cash Price |
$266.74
|
| Rate for Payer: Cofinity Commercial |
$313.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.74
|
| Rate for Payer: Healthscope Commercial |
$333.42
|
| Rate for Payer: Healthscope Whirlpool |
$323.42
|
| Rate for Payer: Mclaren Commercial |
$300.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.41
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$45,321.17
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31,724.82 |
| Max. Negotiated Rate |
$45,321.17 |
| Rate for Payer: Aetna Commercial |
$40,789.05
|
| Rate for Payer: ASR ASR |
$43,961.53
|
| Rate for Payer: BCBS Trust/PPO |
$35,137.50
|
| Rate for Payer: BCN Commercial |
$35,137.50
|
| Rate for Payer: Cash Price |
$36,256.94
|
| Rate for Payer: Cofinity Commercial |
$42,601.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,256.94
|
| Rate for Payer: Healthscope Commercial |
$45,321.17
|
| Rate for Payer: Healthscope Whirlpool |
$43,961.53
|
| Rate for Payer: Mclaren Commercial |
$40,789.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38,522.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31,724.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39,882.63
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$45,321.17
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18,128.47 |
| Max. Negotiated Rate |
$45,321.17 |
| Rate for Payer: Aetna Commercial |
$40,789.05
|
| Rate for Payer: ASR ASR |
$43,961.53
|
| Rate for Payer: BCBS Complete |
$18,128.47
|
| Rate for Payer: BCBS Trust/PPO |
$35,137.50
|
| Rate for Payer: BCN Commercial |
$35,137.50
|
| Rate for Payer: Cash Price |
$36,256.94
|
| Rate for Payer: Cofinity Commercial |
$42,601.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,256.94
|
| Rate for Payer: Healthscope Commercial |
$45,321.17
|
| Rate for Payer: Healthscope Whirlpool |
$43,961.53
|
| Rate for Payer: Mclaren Commercial |
$40,789.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38,522.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31,724.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41,242.26
|
| Rate for Payer: Priority Health Narrow Network |
$32,178.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39,882.63
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$332.79
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.95 |
| Max. Negotiated Rate |
$332.79 |
| Rate for Payer: Aetna Commercial |
$299.51
|
| Rate for Payer: ASR ASR |
$322.81
|
| Rate for Payer: BCBS Trust/PPO |
$258.01
|
| Rate for Payer: BCN Commercial |
$258.01
|
| Rate for Payer: Cash Price |
$266.23
|
| Rate for Payer: Cofinity Commercial |
$312.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.23
|
| Rate for Payer: Healthscope Commercial |
$332.79
|
| Rate for Payer: Healthscope Whirlpool |
$322.81
|
| Rate for Payer: Mclaren Commercial |
$299.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$282.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.86
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$332.79
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.12 |
| Max. Negotiated Rate |
$332.79 |
| Rate for Payer: Aetna Commercial |
$299.51
|
| Rate for Payer: ASR ASR |
$322.81
|
| Rate for Payer: BCBS Complete |
$133.12
|
| Rate for Payer: BCBS Trust/PPO |
$258.01
|
| Rate for Payer: BCN Commercial |
$258.01
|
| Rate for Payer: Cash Price |
$266.23
|
| Rate for Payer: Cofinity Commercial |
$312.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.23
|
| Rate for Payer: Healthscope Commercial |
$332.79
|
| Rate for Payer: Healthscope Whirlpool |
$322.81
|
| Rate for Payer: Mclaren Commercial |
$299.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$282.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.84
|
| Rate for Payer: Priority Health Narrow Network |
$236.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.86
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,873.12
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,011.18 |
| Max. Negotiated Rate |
$2,873.12 |
| Rate for Payer: Aetna Commercial |
$2,585.81
|
| Rate for Payer: ASR ASR |
$2,786.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,227.53
|
| Rate for Payer: BCN Commercial |
$2,227.53
|
| Rate for Payer: Cash Price |
$2,298.50
|
| Rate for Payer: Cofinity Commercial |
$2,700.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,298.50
|
| Rate for Payer: Healthscope Commercial |
$2,873.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,786.93
|
| Rate for Payer: Mclaren Commercial |
$2,585.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,442.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,011.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,528.35
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,873.12
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$2,873.12 |
| Rate for Payer: Aetna Commercial |
$2,585.81
|
| Rate for Payer: ASR ASR |
$2,786.93
|
| Rate for Payer: BCBS Complete |
$1,149.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,227.53
|
| Rate for Payer: BCN Commercial |
$2,227.53
|
| Rate for Payer: Cash Price |
$2,298.50
|
| Rate for Payer: Cash Price |
$2,298.50
|
| Rate for Payer: Cofinity Commercial |
$2,700.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,298.50
|
| Rate for Payer: Healthscope Commercial |
$2,873.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,786.93
|
| Rate for Payer: Mclaren Commercial |
$2,585.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,442.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,011.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,528.35
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,081.01
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,256.71 |
| Max. Negotiated Rate |
$32,293.58 |
| Rate for Payer: Aetna Commercial |
$5,472.91
|
| Rate for Payer: Aetna Medicare |
$25,834.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,293.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,293.58
|
| Rate for Payer: ASR ASR |
$5,898.58
|
| Rate for Payer: BCBS Complete |
$14,839.54
|
| Rate for Payer: BCBS MAPPO |
$25,834.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,714.61
|
| Rate for Payer: BCN Commercial |
$4,714.61
|
| Rate for Payer: BCN Medicare Advantage |
$25,834.86
|
| Rate for Payer: Cash Price |
$4,864.81
|
| Rate for Payer: Cash Price |
$4,864.81
|
| Rate for Payer: Cofinity Commercial |
$5,716.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,864.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,834.86
|
| Rate for Payer: Healthscope Commercial |
$6,081.01
|
| Rate for Payer: Healthscope Whirlpool |
$5,898.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,834.86
|
| Rate for Payer: Mclaren Commercial |
$5,472.91
|
| Rate for Payer: Mclaren Medicaid |
$14,131.67
|
| Rate for Payer: Mclaren Medicare |
$25,834.86
|
| Rate for Payer: Meridian Medicaid |
$14,839.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,126.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,710.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,168.86
|
| Rate for Payer: PACE Medicare |
$24,543.12
|
| Rate for Payer: PACE SWMI |
$25,834.86
|
| Rate for Payer: PHP Commercial |
$28,418.35
|
| Rate for Payer: PHP Medicaid |
$14,131.67
|
| Rate for Payer: PHP Medicare Advantage |
$25,834.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,131.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,256.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31,394.58
|
| Rate for Payer: Priority Health Medicare |
$25,834.86
|
| Rate for Payer: Priority Health Narrow Network |
$25,115.66
|
| Rate for Payer: Railroad Medicare Medicare |
$25,834.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,351.29
|
| Rate for Payer: UHC Medicare Advantage |
$26,609.91
|
| Rate for Payer: VA VA |
$25,834.86
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,081.01
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,256.71 |
| Max. Negotiated Rate |
$6,081.01 |
| Rate for Payer: Aetna Commercial |
$5,472.91
|
| Rate for Payer: ASR ASR |
$5,898.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,714.61
|
| Rate for Payer: BCN Commercial |
$4,714.61
|
| Rate for Payer: Cash Price |
$4,864.81
|
| Rate for Payer: Cofinity Commercial |
$5,716.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,864.81
|
| Rate for Payer: Healthscope Commercial |
$6,081.01
|
| Rate for Payer: Healthscope Whirlpool |
$5,898.58
|
| Rate for Payer: Mclaren Commercial |
$5,472.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,168.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,256.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,351.29
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$70,725.38
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49,507.77 |
| Max. Negotiated Rate |
$70,725.38 |
| Rate for Payer: Aetna Commercial |
$63,652.84
|
| Rate for Payer: ASR ASR |
$68,603.62
|
| Rate for Payer: BCBS Trust/PPO |
$54,833.39
|
| Rate for Payer: BCN Commercial |
$54,833.39
|
| Rate for Payer: Cash Price |
$56,580.30
|
| Rate for Payer: Cofinity Commercial |
$66,481.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56,580.30
|
| Rate for Payer: Healthscope Commercial |
$70,725.38
|
| Rate for Payer: Healthscope Whirlpool |
$68,603.62
|
| Rate for Payer: Mclaren Commercial |
$63,652.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60,116.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49,507.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62,238.33
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$70,725.38
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28,290.15 |
| Max. Negotiated Rate |
$70,725.38 |
| Rate for Payer: Aetna Commercial |
$63,652.84
|
| Rate for Payer: ASR ASR |
$68,603.62
|
| Rate for Payer: BCBS Complete |
$28,290.15
|
| Rate for Payer: BCBS Trust/PPO |
$54,833.39
|
| Rate for Payer: BCN Commercial |
$54,833.39
|
| Rate for Payer: Cash Price |
$56,580.30
|
| Rate for Payer: Cofinity Commercial |
$66,481.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56,580.30
|
| Rate for Payer: Healthscope Commercial |
$70,725.38
|
| Rate for Payer: Healthscope Whirlpool |
$68,603.62
|
| Rate for Payer: Mclaren Commercial |
$63,652.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60,116.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49,507.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64,360.10
|
| Rate for Payer: Priority Health Narrow Network |
$50,215.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62,238.33
|
|
