|
HC FDG PER DOSE
|
Facility
|
IP
|
$793.52
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$595.14 |
| Max. Negotiated Rate |
$793.52 |
| Rate for Payer: Aetna Commercial |
$714.17
|
| Rate for Payer: ASR ASR |
$769.71
|
| Rate for Payer: BCBS Trust/PPO |
$651.64
|
| Rate for Payer: BCN Commercial |
$651.64
|
| Rate for Payer: Cash Price |
$634.82
|
| Rate for Payer: Cofinity Commercial |
$745.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.82
|
| Rate for Payer: Healthscope Commercial |
$769.71
|
| Rate for Payer: Healthscope Whirlpool |
$793.52
|
| Rate for Payer: Mclaren Commercial |
$714.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.49
|
| Rate for Payer: Nomi Health Commercial |
$650.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$698.30
|
|
|
HC FDG PER DOSE
|
Facility
|
OP
|
$793.52
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$257.01 |
| Max. Negotiated Rate |
$793.52 |
| Rate for Payer: Aetna Commercial |
$714.17
|
| Rate for Payer: Aetna Medicare |
$293.60
|
| Rate for Payer: ASR ASR |
$769.71
|
| Rate for Payer: BCBS Complete |
$317.41
|
| Rate for Payer: BCBS Trust/PPO |
$654.26
|
| Rate for Payer: BCN Commercial |
$654.26
|
| Rate for Payer: Cash Price |
$634.82
|
| Rate for Payer: Cash Price |
$634.82
|
| Rate for Payer: Cofinity Commercial |
$745.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.82
|
| Rate for Payer: Healthscope Commercial |
$769.71
|
| Rate for Payer: Healthscope Whirlpool |
$793.52
|
| Rate for Payer: Mclaren Commercial |
$714.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.49
|
| Rate for Payer: Nomi Health Commercial |
$650.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$321.26
|
| Rate for Payer: Priority Health Narrow Network |
$257.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$698.30
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
IP
|
$34.90
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$34.90 |
| Rate for Payer: Aetna Commercial |
$31.41
|
| Rate for Payer: ASR ASR |
$33.85
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$28.66
|
| Rate for Payer: Cash Price |
$27.92
|
| Rate for Payer: Cofinity Commercial |
$32.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.92
|
| Rate for Payer: Healthscope Commercial |
$33.85
|
| Rate for Payer: Healthscope Whirlpool |
$34.90
|
| Rate for Payer: Mclaren Commercial |
$31.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.66
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.71
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
OP
|
$34.90
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$48.43 |
| Rate for Payer: Aetna Commercial |
$31.41
|
| Rate for Payer: Aetna Medicare |
$5.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: ASR ASR |
$33.85
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$28.78
|
| Rate for Payer: BCN Commercial |
$28.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$27.92
|
| Rate for Payer: Cash Price |
$27.92
|
| Rate for Payer: Cofinity Commercial |
$32.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$33.85
|
| Rate for Payer: Healthscope Whirlpool |
$34.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.10
|
| Rate for Payer: Mclaren Commercial |
$31.41
|
| Rate for Payer: Mclaren Medicaid |
$5.10
|
| Rate for Payer: Mclaren Medicare |
$5.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: Meridian Medicaid |
$2.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.66
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.18
|
| Rate for Payer: PACE Medicare |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$5.61
|
| Rate for Payer: PHP Medicaid |
$2.73
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.43
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow Network |
$38.74
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.10
|
| Rate for Payer: UHC Exchange |
$7.91
|
| Rate for Payer: UHC Medicaid |
$2.67
|
| Rate for Payer: UHCCP DNSP |
$5.10
|
| Rate for Payer: UHCCP Medicaid |
$2.67
|
| Rate for Payer: VA VA |
$5.10
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.62 |
| Max. Negotiated Rate |
$72.83 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: ASR ASR |
$70.65
|
| Rate for Payer: BCBS Trust/PPO |
$59.81
|
| Rate for Payer: BCN Commercial |
$59.81
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$70.65
|
| Rate for Payer: Healthscope Whirlpool |
$72.83
|
| Rate for Payer: Mclaren Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.09
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$72.83 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Medicare |
$16.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: ASR ASR |
$70.65
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$60.05
|
| Rate for Payer: BCN Commercial |
$60.05
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$70.65
|
| Rate for Payer: Healthscope Whirlpool |
$72.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.80
|
| Rate for Payer: Mclaren Commercial |
$65.55
|
| Rate for Payer: Mclaren Medicaid |
$16.80
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$18.48
|
| Rate for Payer: PHP Medicaid |
$9.00
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63.81
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health Narrow Network |
$51.05
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.80
|
| Rate for Payer: UHC Exchange |
$26.04
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHCCP DNSP |
$16.80
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$16.80
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$54.94 |
| Rate for Payer: Aetna Commercial |
$49.45
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$53.29
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$45.30
|
| Rate for Payer: BCN Commercial |
$45.30
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$51.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$53.29
|
| Rate for Payer: Healthscope Whirlpool |
$54.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$49.45
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.31
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$29.05
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP DNSP |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$54.94 |
| Rate for Payer: Aetna Commercial |
$49.45
|
| Rate for Payer: ASR ASR |
$53.29
|
| Rate for Payer: BCBS Trust/PPO |
$45.12
|
| Rate for Payer: BCN Commercial |
$45.12
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$51.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$53.29
|
| Rate for Payer: Healthscope Whirlpool |
$54.94
|
| Rate for Payer: Mclaren Commercial |
$49.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.35
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
OP
|
$1,333.47
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$1,293.47
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.45
|
| Rate for Payer: BCN Commercial |
$1,099.45
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,066.78
|
| Rate for Payer: Cash Price |
$1,066.78
|
| Rate for Payer: Cofinity Commercial |
$1,253.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,293.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,333.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$1,200.12
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.45
|
| Rate for Payer: Nomi Health Commercial |
$1,093.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.10
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.39
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$934.76
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,173.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Exchange |
$1,400.77
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
IP
|
$1,333.47
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,000.10 |
| Max. Negotiated Rate |
$1,333.47 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: ASR ASR |
$1,293.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.05
|
| Rate for Payer: BCN Commercial |
$1,095.05
|
| Rate for Payer: Cash Price |
$1,066.78
|
| Rate for Payer: Cofinity Commercial |
$1,253.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.78
|
| Rate for Payer: Healthscope Commercial |
$1,293.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,333.47
|
| Rate for Payer: Mclaren Commercial |
$1,200.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.45
|
| Rate for Payer: Nomi Health Commercial |
$1,093.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,173.45
|
|
|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.87 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: BCBS Trust/PPO |
$26.14
|
| Rate for Payer: BCN Commercial |
$26.14
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$30.88
|
| Rate for Payer: Healthscope Whirlpool |
$31.83
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
|
|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.33 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: Aetna Medicare |
$15.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$26.24
|
| Rate for Payer: BCN Commercial |
$26.24
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$30.88
|
| Rate for Payer: Healthscope Whirlpool |
$31.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.92
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$15.92
|
| Rate for Payer: Mclaren Medicare |
$15.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.72
|
| Rate for Payer: Meridian Medicaid |
$8.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Medicare |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$17.51
|
| Rate for Payer: PHP Medicaid |
$8.53
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.89
|
| Rate for Payer: Priority Health Medicare |
$15.92
|
| Rate for Payer: Priority Health Narrow Network |
$22.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.92
|
| Rate for Payer: UHC Exchange |
$24.68
|
| Rate for Payer: UHC Medicaid |
$8.33
|
| Rate for Payer: UHCCP DNSP |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$8.33
|
| Rate for Payer: VA VA |
$15.92
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.47
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCBS Trust/PPO |
$25.73
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.38
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$4.38
|
| Rate for Payer: Mclaren Medicare |
$4.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$4.16
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Commercial |
$4.82
|
| Rate for Payer: PHP Medicaid |
$2.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.50
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Narrow Network |
$46.00
|
| Rate for Payer: Railroad Medicare Medicare |
$4.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.38
|
| Rate for Payer: UHC Exchange |
$6.79
|
| Rate for Payer: UHC Medicaid |
$2.29
|
| Rate for Payer: UHCCP DNSP |
$4.38
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: VA VA |
$4.38
|
|
|
HC FECAL PH
|
Facility
|
OP
|
$24.41
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Aetna Commercial |
$21.97
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.47
|
| Rate for Payer: ASR ASR |
$23.68
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.13
|
| Rate for Payer: BCN Commercial |
$20.13
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$23.68
|
| Rate for Payer: Healthscope Whirlpool |
$24.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.58
|
| Rate for Payer: Mclaren Commercial |
$21.97
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$3.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: Meridian Medicaid |
$1.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: PACE Medicare |
$3.40
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: PHP Medicaid |
$1.92
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: Priority Health Narrow Network |
$12.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.58
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicaid |
$1.87
|
| Rate for Payer: UHCCP DNSP |
$3.58
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
| Rate for Payer: VA VA |
$3.58
|
|
|
HC FECAL PH
|
Facility
|
IP
|
$24.41
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Aetna Commercial |
$21.97
|
| Rate for Payer: ASR ASR |
$23.68
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$20.05
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Healthscope Commercial |
$23.68
|
| Rate for Payer: Healthscope Whirlpool |
$24.41
|
| Rate for Payer: Mclaren Commercial |
$21.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.48
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.26 |
| Max. Negotiated Rate |
$52.34 |
| Rate for Payer: Aetna Commercial |
$47.11
|
| Rate for Payer: ASR ASR |
$50.77
|
| Rate for Payer: BCBS Trust/PPO |
$42.98
|
| Rate for Payer: BCN Commercial |
$42.98
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$49.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$50.77
|
| Rate for Payer: Healthscope Whirlpool |
$52.34
|
| Rate for Payer: Mclaren Commercial |
$47.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.06
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$52.34 |
| Rate for Payer: Aetna Commercial |
$47.11
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.88
|
| Rate for Payer: ASR ASR |
$50.77
|
| Rate for Payer: BCBS Complete |
$3.02
|
| Rate for Payer: BCBS MAPPO |
$5.50
|
| Rate for Payer: BCBS Trust/PPO |
$43.15
|
| Rate for Payer: BCN Commercial |
$43.15
|
| Rate for Payer: BCN Medicare Advantage |
$5.50
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$49.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.50
|
| Rate for Payer: Healthscope Commercial |
$50.77
|
| Rate for Payer: Healthscope Whirlpool |
$52.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.50
|
| Rate for Payer: Mclaren Commercial |
$47.11
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Mclaren Medicare |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.78
|
| Rate for Payer: Meridian Medicaid |
$3.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PACE Medicare |
$5.22
|
| Rate for Payer: PACE SWMI |
$5.50
|
| Rate for Payer: PHP Commercial |
$6.05
|
| Rate for Payer: PHP Medicaid |
$2.95
|
| Rate for Payer: PHP Medicare Advantage |
$5.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.16
|
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow Network |
$14.53
|
| Rate for Payer: Railroad Medicare Medicare |
$5.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.50
|
| Rate for Payer: UHC Exchange |
$8.53
|
| Rate for Payer: UHC Medicaid |
$2.88
|
| Rate for Payer: UHCCP DNSP |
$5.50
|
| Rate for Payer: UHCCP Medicaid |
$2.88
|
| Rate for Payer: VA VA |
$5.50
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
IP
|
$76.84
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$76.84 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: ASR ASR |
$74.53
|
| Rate for Payer: BCBS Trust/PPO |
$63.10
|
| Rate for Payer: BCN Commercial |
$63.10
|
| Rate for Payer: Cash Price |
$61.47
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.47
|
| Rate for Payer: Healthscope Commercial |
$74.53
|
| Rate for Payer: Healthscope Whirlpool |
$76.84
|
| Rate for Payer: Mclaren Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.62
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
OP
|
$76.84
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$76.84 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: Aetna Medicare |
$19.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.62
|
| Rate for Payer: ASR ASR |
$74.53
|
| Rate for Payer: BCBS Complete |
$10.82
|
| Rate for Payer: BCBS MAPPO |
$19.70
|
| Rate for Payer: BCBS Trust/PPO |
$63.35
|
| Rate for Payer: BCN Commercial |
$63.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.70
|
| Rate for Payer: Cash Price |
$61.47
|
| Rate for Payer: Cash Price |
$61.47
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.70
|
| Rate for Payer: Healthscope Commercial |
$74.53
|
| Rate for Payer: Healthscope Whirlpool |
$76.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.70
|
| Rate for Payer: Mclaren Commercial |
$69.16
|
| Rate for Payer: Mclaren Medicaid |
$19.70
|
| Rate for Payer: Mclaren Medicare |
$19.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.68
|
| Rate for Payer: Meridian Medicaid |
$10.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.63
|
| Rate for Payer: PACE Medicare |
$18.71
|
| Rate for Payer: PACE SWMI |
$19.70
|
| Rate for Payer: PHP Commercial |
$21.67
|
| Rate for Payer: PHP Medicaid |
$10.56
|
| Rate for Payer: PHP Medicare Advantage |
$19.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.33
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow Network |
$53.86
|
| Rate for Payer: Railroad Medicare Medicare |
$19.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.70
|
| Rate for Payer: UHC Exchange |
$30.54
|
| Rate for Payer: UHC Medicaid |
$10.30
|
| Rate for Payer: UHCCP DNSP |
$19.70
|
| Rate for Payer: UHCCP Medicaid |
$10.30
|
| Rate for Payer: VA VA |
$19.70
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$271.17 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.50
|
| Rate for Payer: PHP Medicaid |
$9.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$271.17
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$216.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
|
|
HC FEMOSTOP
|
Facility
|
OP
|
$489.41
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.08 |
| Max. Negotiated Rate |
$489.41 |
| Rate for Payer: Aetna Commercial |
$440.47
|
| Rate for Payer: Aetna Medicare |
$181.08
|
| Rate for Payer: ASR ASR |
$474.73
|
| Rate for Payer: BCBS Complete |
$195.76
|
| Rate for Payer: BCBS Trust/PPO |
$403.52
|
| Rate for Payer: BCN Commercial |
$403.52
|
| Rate for Payer: Cash Price |
$391.53
|
| Rate for Payer: Cofinity Commercial |
$460.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.53
|
| Rate for Payer: Healthscope Commercial |
$474.73
|
| Rate for Payer: Healthscope Whirlpool |
$489.41
|
| Rate for Payer: Mclaren Commercial |
$440.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$391.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.00
|
| Rate for Payer: Nomi Health Commercial |
$401.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$428.82
|
| Rate for Payer: Priority Health Narrow Network |
$343.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.68
|
|
|
HC FEMOSTOP
|
Facility
|
IP
|
$489.41
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$367.06 |
| Max. Negotiated Rate |
$489.41 |
| Rate for Payer: Aetna Commercial |
$440.47
|
| Rate for Payer: ASR ASR |
$474.73
|
| Rate for Payer: BCBS Trust/PPO |
$401.90
|
| Rate for Payer: BCN Commercial |
$401.90
|
| Rate for Payer: Cash Price |
$391.53
|
| Rate for Payer: Cofinity Commercial |
$460.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.53
|
| Rate for Payer: Healthscope Commercial |
$474.73
|
| Rate for Payer: Healthscope Whirlpool |
$489.41
|
| Rate for Payer: Mclaren Commercial |
$440.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.00
|
| Rate for Payer: Nomi Health Commercial |
$401.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.68
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
OP
|
$363.63
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$363.63 |
| Rate for Payer: Aetna Commercial |
$327.27
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$352.72
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$299.81
|
| Rate for Payer: BCN Commercial |
$299.81
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$290.90
|
| Rate for Payer: Cash Price |
$290.90
|
| Rate for Payer: Cofinity Commercial |
$341.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$352.72
|
| Rate for Payer: Healthscope Whirlpool |
$363.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$327.27
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.09
|
| Rate for Payer: Nomi Health Commercial |
$298.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.72
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$318.61
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$254.90
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
