|
HC ENSITE NAVX KIT
|
Facility
|
OP
|
$4,897.16
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,811.95 |
| Max. Negotiated Rate |
$4,897.16 |
| Rate for Payer: Aetna Commercial |
$4,407.44
|
| Rate for Payer: Aetna Medicare |
$1,811.95
|
| Rate for Payer: ASR ASR |
$4,750.25
|
| Rate for Payer: BCBS Complete |
$1,958.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,037.71
|
| Rate for Payer: BCN Commercial |
$4,037.71
|
| Rate for Payer: Cash Price |
$3,917.73
|
| Rate for Payer: Cofinity Commercial |
$4,603.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,917.73
|
| Rate for Payer: Healthscope Commercial |
$4,750.25
|
| Rate for Payer: Healthscope Whirlpool |
$4,897.16
|
| Rate for Payer: Mclaren Commercial |
$4,407.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,917.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,162.59
|
| Rate for Payer: Nomi Health Commercial |
$4,015.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,290.89
|
| Rate for Payer: Priority Health Narrow Network |
$3,432.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,309.50
|
|
|
HC ENTEROVIRUS
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| 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 |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| 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 |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
IP
|
$249.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$187.28 |
| Max. Negotiated Rate |
$249.70 |
| Rate for Payer: Aetna Commercial |
$224.73
|
| Rate for Payer: ASR ASR |
$242.21
|
| Rate for Payer: BCBS Trust/PPO |
$205.05
|
| Rate for Payer: BCN Commercial |
$205.05
|
| Rate for Payer: Cash Price |
$199.76
|
| Rate for Payer: Cofinity Commercial |
$234.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.76
|
| Rate for Payer: Healthscope Commercial |
$242.21
|
| Rate for Payer: Healthscope Whirlpool |
$249.70
|
| Rate for Payer: Mclaren Commercial |
$224.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.25
|
| Rate for Payer: Nomi Health Commercial |
$204.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.74
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
OP
|
$249.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$249.70 |
| Rate for Payer: Aetna Commercial |
$224.73
|
| 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 |
$242.21
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$205.88
|
| Rate for Payer: BCN Commercial |
$205.88
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$199.76
|
| Rate for Payer: Cash Price |
$199.76
|
| Rate for Payer: Cofinity Commercial |
$234.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$242.21
|
| Rate for Payer: Healthscope Whirlpool |
$249.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$224.73
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.25
|
| Rate for Payer: Nomi Health Commercial |
$204.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.28
|
| 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 |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$218.79
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$175.04
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
IP
|
$209.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$157.38 |
| Max. Negotiated Rate |
$209.84 |
| Rate for Payer: Aetna Commercial |
$188.86
|
| Rate for Payer: ASR ASR |
$203.54
|
| Rate for Payer: BCBS Trust/PPO |
$172.32
|
| Rate for Payer: BCN Commercial |
$172.32
|
| Rate for Payer: Cash Price |
$167.87
|
| Rate for Payer: Cofinity Commercial |
$197.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.87
|
| Rate for Payer: Healthscope Commercial |
$203.54
|
| Rate for Payer: Healthscope Whirlpool |
$209.84
|
| Rate for Payer: Mclaren Commercial |
$188.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.36
|
| Rate for Payer: Nomi Health Commercial |
$172.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.66
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
OP
|
$209.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$209.84 |
| Rate for Payer: Aetna Commercial |
$188.86
|
| 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 |
$203.54
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$173.01
|
| Rate for Payer: BCN Commercial |
$173.01
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$167.87
|
| Rate for Payer: Cash Price |
$167.87
|
| Rate for Payer: Cofinity Commercial |
$197.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$203.54
|
| Rate for Payer: Healthscope Whirlpool |
$209.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$188.86
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.36
|
| Rate for Payer: Nomi Health Commercial |
$172.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.38
|
| 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 |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$183.86
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$147.10
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$75.61 |
| Max. Negotiated Rate |
$100.82 |
| Rate for Payer: Aetna Commercial |
$90.74
|
| Rate for Payer: ASR ASR |
$97.80
|
| Rate for Payer: BCBS Trust/PPO |
$82.79
|
| Rate for Payer: BCN Commercial |
$82.79
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$97.80
|
| Rate for Payer: Healthscope Whirlpool |
$100.82
|
| Rate for Payer: Mclaren Commercial |
$90.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.72
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$100.82 |
| Rate for Payer: Aetna Commercial |
$90.74
|
| 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 |
$97.80
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$83.13
|
| Rate for Payer: BCN Commercial |
$83.13
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$97.80
|
| Rate for Payer: Healthscope Whirlpool |
$100.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$90.74
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| 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 |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.34
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$70.67
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$38.31
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$34.48
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: ASR ASR |
$37.16
|
| Rate for Payer: BCBS Complete |
$4.73
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$31.59
|
| Rate for Payer: BCN Commercial |
$31.59
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Commercial |
$36.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$37.16
|
| Rate for Payer: Healthscope Whirlpool |
$38.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.62
|
| Rate for Payer: Mclaren Commercial |
$34.48
|
| Rate for Payer: Mclaren Medicaid |
$8.62
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Meridian Medicaid |
$4.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Nomi Health Commercial |
$31.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$9.48
|
| Rate for Payer: PHP Medicaid |
$4.62
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.02
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.62
|
| Rate for Payer: UHC Exchange |
$13.36
|
| Rate for Payer: UHC Medicaid |
$4.51
|
| Rate for Payer: UHCCP DNSP |
$8.62
|
| Rate for Payer: UHCCP Medicaid |
$4.51
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$38.31
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.73 |
| Max. Negotiated Rate |
$38.31 |
| Rate for Payer: Aetna Commercial |
$34.48
|
| Rate for Payer: ASR ASR |
$37.16
|
| Rate for Payer: BCBS Trust/PPO |
$31.46
|
| Rate for Payer: BCN Commercial |
$31.46
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Commercial |
$36.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Healthscope Commercial |
$37.16
|
| Rate for Payer: Healthscope Whirlpool |
$38.31
|
| Rate for Payer: Mclaren Commercial |
$34.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Nomi Health Commercial |
$31.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.71
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$29.86
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$29.86 |
| Rate for Payer: Aetna Commercial |
$26.87
|
| Rate for Payer: ASR ASR |
$28.96
|
| Rate for Payer: BCBS Trust/PPO |
$24.52
|
| Rate for Payer: BCN Commercial |
$24.52
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Healthscope Commercial |
$28.96
|
| Rate for Payer: Healthscope Whirlpool |
$29.86
|
| Rate for Payer: Mclaren Commercial |
$26.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$24.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.28
|
|
|
HC ENZYME DETECTION
|
Facility
|
OP
|
$29.86
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$29.86 |
| Rate for Payer: Aetna Commercial |
$26.87
|
| Rate for Payer: Aetna Medicare |
$4.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: ASR ASR |
$28.96
|
| Rate for Payer: BCBS Complete |
$2.61
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$24.62
|
| Rate for Payer: BCN Commercial |
$24.62
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$28.96
|
| Rate for Payer: Healthscope Whirlpool |
$29.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.75
|
| Rate for Payer: Mclaren Commercial |
$26.87
|
| Rate for Payer: Mclaren Medicaid |
$4.75
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$2.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$24.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.39
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$5.22
|
| Rate for Payer: PHP Medicaid |
$2.55
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.16
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health Narrow Network |
$20.93
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.75
|
| Rate for Payer: UHC Exchange |
$7.36
|
| Rate for Payer: UHC Medicaid |
$2.48
|
| Rate for Payer: UHCCP DNSP |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$168.54
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$118.15 |
| Max. Negotiated Rate |
$1,244.31 |
| Rate for Payer: Aetna Commercial |
$151.69
|
| Rate for Payer: Aetna Medicare |
$802.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: ASR ASR |
$163.48
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$138.96
|
| Rate for Payer: BCN Commercial |
$138.96
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$158.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$163.48
|
| Rate for Payer: Healthscope Whirlpool |
$168.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$802.78
|
| Rate for Payer: Mclaren Commercial |
$151.69
|
| Rate for Payer: Mclaren Medicaid |
$802.78
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$440.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$138.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.41
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$883.06
|
| Rate for Payer: PHP Medicaid |
$430.29
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$147.67
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health Narrow Network |
$118.15
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,244.31
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP DNSP |
$802.78
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: VA VA |
$802.78
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$168.54
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$126.41 |
| Max. Negotiated Rate |
$168.54 |
| Rate for Payer: Aetna Commercial |
$151.69
|
| Rate for Payer: ASR ASR |
$163.48
|
| Rate for Payer: BCBS Trust/PPO |
$138.41
|
| Rate for Payer: BCN Commercial |
$138.41
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$158.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Healthscope Commercial |
$163.48
|
| Rate for Payer: Healthscope Whirlpool |
$168.54
|
| Rate for Payer: Mclaren Commercial |
$151.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$138.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.32
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$47.24 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.24
|
| Rate for Payer: ASR ASR |
$45.82
|
| Rate for Payer: BCBS Complete |
$3.18
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$38.95
|
| Rate for Payer: BCN Commercial |
$38.95
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$44.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.79
|
| Rate for Payer: Mclaren Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$5.79
|
| Rate for Payer: Mclaren Medicare |
$5.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.08
|
| Rate for Payer: Meridian Medicaid |
$3.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Medicare |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$6.37
|
| Rate for Payer: PHP Medicaid |
$3.10
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.18
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health Narrow Network |
$16.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.79
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicaid |
$3.03
|
| Rate for Payer: UHCCP DNSP |
$5.79
|
| Rate for Payer: UHCCP Medicaid |
$3.03
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$47.24 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: ASR ASR |
$45.82
|
| Rate for Payer: BCBS Trust/PPO |
$38.79
|
| Rate for Payer: BCN Commercial |
$38.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$44.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.24
|
| Rate for Payer: Mclaren Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.57
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$31.94
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.95 |
| Max. Negotiated Rate |
$31.94 |
| Rate for Payer: Aetna Commercial |
$28.75
|
| Rate for Payer: ASR ASR |
$30.98
|
| Rate for Payer: BCBS Trust/PPO |
$26.23
|
| Rate for Payer: BCN Commercial |
$26.23
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cofinity Commercial |
$30.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.55
|
| Rate for Payer: Healthscope Commercial |
$30.98
|
| Rate for Payer: Healthscope Whirlpool |
$31.94
|
| Rate for Payer: Mclaren Commercial |
$28.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.15
|
| Rate for Payer: Nomi Health Commercial |
$26.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.11
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$31.94
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$31.94 |
| Rate for Payer: Aetna Commercial |
$28.75
|
| Rate for Payer: Aetna Medicare |
$11.82
|
| Rate for Payer: ASR ASR |
$30.98
|
| Rate for Payer: BCBS Complete |
$12.78
|
| Rate for Payer: BCBS Trust/PPO |
$26.33
|
| Rate for Payer: BCN Commercial |
$26.33
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cofinity Commercial |
$30.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.55
|
| Rate for Payer: Healthscope Commercial |
$30.98
|
| Rate for Payer: Healthscope Whirlpool |
$31.94
|
| Rate for Payer: Mclaren Commercial |
$28.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.15
|
| Rate for Payer: Nomi Health Commercial |
$26.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15.31
|
| Rate for Payer: Priority Health Narrow Network |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.11
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$281.22
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$210.91 |
| Max. Negotiated Rate |
$281.22 |
| Rate for Payer: Aetna Commercial |
$253.10
|
| Rate for Payer: ASR ASR |
$272.78
|
| Rate for Payer: BCBS Trust/PPO |
$230.94
|
| Rate for Payer: BCN Commercial |
$230.94
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$264.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$272.78
|
| Rate for Payer: Healthscope Whirlpool |
$281.22
|
| Rate for Payer: Mclaren Commercial |
$253.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.47
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$281.22
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$104.05 |
| Max. Negotiated Rate |
$281.22 |
| Rate for Payer: Aetna Commercial |
$253.10
|
| Rate for Payer: Aetna Medicare |
$104.05
|
| Rate for Payer: ASR ASR |
$272.78
|
| Rate for Payer: BCBS Complete |
$112.49
|
| Rate for Payer: BCBS Trust/PPO |
$231.87
|
| Rate for Payer: BCN Commercial |
$231.87
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$264.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$272.78
|
| Rate for Payer: Healthscope Whirlpool |
$281.22
|
| Rate for Payer: Mclaren Commercial |
$253.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$224.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$246.40
|
| Rate for Payer: Priority Health Narrow Network |
$197.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.47
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
IP
|
$18,094.29
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,570.72 |
| Max. Negotiated Rate |
$18,094.29 |
| Rate for Payer: Aetna Commercial |
$16,284.86
|
| Rate for Payer: ASR ASR |
$17,551.46
|
| Rate for Payer: BCBS Trust/PPO |
$14,859.03
|
| Rate for Payer: BCN Commercial |
$14,859.03
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Commercial |
$17,008.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Healthscope Commercial |
$17,551.46
|
| Rate for Payer: Healthscope Whirlpool |
$18,094.29
|
| Rate for Payer: Mclaren Commercial |
$16,284.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Nomi Health Commercial |
$14,837.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,922.98
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
OP
|
$18,094.29
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,254.97 |
| Max. Negotiated Rate |
$40,368.00 |
| Rate for Payer: Aetna Commercial |
$16,284.86
|
| Rate for Payer: Aetna Medicare |
$26,043.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,554.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,554.84
|
| Rate for Payer: ASR ASR |
$17,551.46
|
| Rate for Payer: BCBS Complete |
$14,303.29
|
| Rate for Payer: BCBS MAPPO |
$26,043.87
|
| Rate for Payer: BCBS Trust/PPO |
$14,918.74
|
| Rate for Payer: BCN Commercial |
$14,918.74
|
| Rate for Payer: BCN Medicare Advantage |
$26,043.87
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Commercial |
$17,008.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,043.87
|
| Rate for Payer: Healthscope Commercial |
$17,551.46
|
| Rate for Payer: Healthscope Whirlpool |
$18,094.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,043.87
|
| Rate for Payer: Mclaren Commercial |
$16,284.86
|
| Rate for Payer: Mclaren Medicaid |
$26,043.87
|
| Rate for Payer: Mclaren Medicare |
$26,043.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,346.06
|
| Rate for Payer: Meridian Medicaid |
$14,303.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,950.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,648.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Nomi Health Commercial |
$14,837.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: PACE Medicare |
$24,741.68
|
| Rate for Payer: PACE SWMI |
$26,043.87
|
| Rate for Payer: PHP Commercial |
$28,648.26
|
| Rate for Payer: PHP Medicaid |
$13,959.51
|
| Rate for Payer: PHP Medicare Advantage |
$26,043.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,620.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14,068.71
|
| Rate for Payer: Priority Health Medicare |
$26,043.87
|
| Rate for Payer: Priority Health Narrow Network |
$11,254.97
|
| Rate for Payer: Railroad Medicare Medicare |
$26,043.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,922.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,043.87
|
| Rate for Payer: UHC Exchange |
$40,368.00
|
| Rate for Payer: UHC Medicaid |
$13,620.94
|
| Rate for Payer: UHCCP DNSP |
$26,043.87
|
| Rate for Payer: UHCCP Medicaid |
$13,620.94
|
| Rate for Payer: VA VA |
$26,043.87
|
|
|
HC EP+ABL VT
|
Facility
|
IP
|
$18,094.29
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,570.72 |
| Max. Negotiated Rate |
$18,094.29 |
| Rate for Payer: Aetna Commercial |
$16,284.86
|
| Rate for Payer: ASR ASR |
$17,551.46
|
| Rate for Payer: BCBS Trust/PPO |
$14,859.03
|
| Rate for Payer: BCN Commercial |
$14,859.03
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Commercial |
$17,008.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Healthscope Commercial |
$17,551.46
|
| Rate for Payer: Healthscope Whirlpool |
$18,094.29
|
| Rate for Payer: Mclaren Commercial |
$16,284.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Nomi Health Commercial |
$14,837.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,922.98
|
|
|
HC EP+ABL VT
|
Facility
|
OP
|
$18,094.29
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,254.97 |
| Max. Negotiated Rate |
$40,368.00 |
| Rate for Payer: Aetna Commercial |
$16,284.86
|
| Rate for Payer: Aetna Medicare |
$26,043.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,554.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,554.84
|
| Rate for Payer: ASR ASR |
$17,551.46
|
| Rate for Payer: BCBS Complete |
$14,303.29
|
| Rate for Payer: BCBS MAPPO |
$26,043.87
|
| Rate for Payer: BCBS Trust/PPO |
$14,918.74
|
| Rate for Payer: BCN Commercial |
$14,918.74
|
| Rate for Payer: BCN Medicare Advantage |
$26,043.87
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cash Price |
$14,475.43
|
| Rate for Payer: Cofinity Commercial |
$17,008.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,475.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,043.87
|
| Rate for Payer: Healthscope Commercial |
$17,551.46
|
| Rate for Payer: Healthscope Whirlpool |
$18,094.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,043.87
|
| Rate for Payer: Mclaren Commercial |
$16,284.86
|
| Rate for Payer: Mclaren Medicaid |
$26,043.87
|
| Rate for Payer: Mclaren Medicare |
$26,043.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,346.06
|
| Rate for Payer: Meridian Medicaid |
$14,303.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,950.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,648.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,380.15
|
| Rate for Payer: Nomi Health Commercial |
$14,837.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,570.72
|
| Rate for Payer: PACE Medicare |
$24,741.68
|
| Rate for Payer: PACE SWMI |
$26,043.87
|
| Rate for Payer: PHP Commercial |
$28,648.26
|
| Rate for Payer: PHP Medicaid |
$13,959.51
|
| Rate for Payer: PHP Medicare Advantage |
$26,043.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,620.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14,068.71
|
| Rate for Payer: Priority Health Medicare |
$26,043.87
|
| Rate for Payer: Priority Health Narrow Network |
$11,254.97
|
| Rate for Payer: Railroad Medicare Medicare |
$26,043.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,922.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,043.87
|
| Rate for Payer: UHC Exchange |
$40,368.00
|
| Rate for Payer: UHC Medicaid |
$13,620.94
|
| Rate for Payer: UHCCP DNSP |
$26,043.87
|
| Rate for Payer: UHCCP Medicaid |
$13,620.94
|
| Rate for Payer: VA VA |
$26,043.87
|
|
