|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$195.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$175.50
|
| Rate for Payer: ASR ASR |
$189.15
|
| Rate for Payer: BCBS Complete |
$78.00
|
| Rate for Payer: BCBS Trust/PPO |
$151.18
|
| Rate for Payer: BCN Commercial |
$151.18
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$183.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.00
|
| Rate for Payer: Healthscope Commercial |
$195.00
|
| Rate for Payer: Healthscope Whirlpool |
$189.15
|
| Rate for Payer: Mclaren Commercial |
$175.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.45
|
| Rate for Payer: Priority Health Narrow Network |
$138.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.60
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$195.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$175.50
|
| Rate for Payer: ASR ASR |
$189.15
|
| Rate for Payer: BCBS Trust/PPO |
$151.18
|
| Rate for Payer: BCN Commercial |
$151.18
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$183.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.00
|
| Rate for Payer: Healthscope Commercial |
$195.00
|
| Rate for Payer: Healthscope Whirlpool |
$189.15
|
| Rate for Payer: Mclaren Commercial |
$175.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.60
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,868.17
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,909.37 |
| Max. Negotiated Rate |
$4,363.29 |
| Rate for Payer: Aetna Commercial |
$2,581.35
|
| Rate for Payer: Aetna Medicare |
$3,490.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,363.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,363.29
|
| Rate for Payer: ASR ASR |
$2,782.12
|
| Rate for Payer: BCBS Complete |
$2,005.02
|
| Rate for Payer: BCBS MAPPO |
$3,490.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.69
|
| Rate for Payer: BCN Commercial |
$2,223.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,490.63
|
| Rate for Payer: Cash Price |
$2,294.54
|
| Rate for Payer: Cash Price |
$2,294.54
|
| Rate for Payer: Cofinity Commercial |
$2,696.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,294.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,490.63
|
| Rate for Payer: Healthscope Commercial |
$2,868.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,782.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,490.63
|
| Rate for Payer: Mclaren Commercial |
$2,581.35
|
| Rate for Payer: Mclaren Medicaid |
$1,909.37
|
| Rate for Payer: Mclaren Medicare |
$3,490.63
|
| Rate for Payer: Meridian Medicaid |
$2,005.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,665.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,014.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,437.94
|
| Rate for Payer: PACE Medicare |
$3,316.10
|
| Rate for Payer: PACE SWMI |
$3,490.63
|
| Rate for Payer: PHP Commercial |
$3,839.69
|
| Rate for Payer: PHP Medicaid |
$1,909.37
|
| Rate for Payer: PHP Medicare Advantage |
$3,490.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,909.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,610.03
|
| Rate for Payer: Priority Health Medicare |
$3,490.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,036.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3,490.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,523.99
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.35
|
| Rate for Payer: VA VA |
$3,490.63
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,868.17
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,007.72 |
| Max. Negotiated Rate |
$2,868.17 |
| Rate for Payer: Aetna Commercial |
$2,581.35
|
| Rate for Payer: ASR ASR |
$2,782.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.69
|
| Rate for Payer: BCN Commercial |
$2,223.69
|
| Rate for Payer: Cash Price |
$2,294.54
|
| Rate for Payer: Cofinity Commercial |
$2,696.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,294.54
|
| Rate for Payer: Healthscope Commercial |
$2,868.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,782.12
|
| Rate for Payer: Mclaren Commercial |
$2,581.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,437.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,523.99
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,632.23
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,542.56 |
| Max. Negotiated Rate |
$3,632.23 |
| Rate for Payer: Aetna Commercial |
$3,269.01
|
| Rate for Payer: ASR ASR |
$3,523.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,816.07
|
| Rate for Payer: BCN Commercial |
$2,816.07
|
| Rate for Payer: Cash Price |
$2,905.78
|
| Rate for Payer: Cofinity Commercial |
$3,414.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.78
|
| Rate for Payer: Healthscope Commercial |
$3,632.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,523.26
|
| Rate for Payer: Mclaren Commercial |
$3,269.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,087.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,196.36
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,632.23
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,909.37 |
| Max. Negotiated Rate |
$4,363.29 |
| Rate for Payer: Aetna Commercial |
$3,269.01
|
| Rate for Payer: Aetna Medicare |
$3,490.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,363.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,363.29
|
| Rate for Payer: ASR ASR |
$3,523.26
|
| Rate for Payer: BCBS Complete |
$2,005.02
|
| Rate for Payer: BCBS MAPPO |
$3,490.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,816.07
|
| Rate for Payer: BCN Commercial |
$2,816.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,490.63
|
| Rate for Payer: Cash Price |
$2,905.78
|
| Rate for Payer: Cash Price |
$2,905.78
|
| Rate for Payer: Cofinity Commercial |
$3,414.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,490.63
|
| Rate for Payer: Healthscope Commercial |
$3,632.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,523.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,490.63
|
| Rate for Payer: Mclaren Commercial |
$3,269.01
|
| Rate for Payer: Mclaren Medicaid |
$1,909.37
|
| Rate for Payer: Mclaren Medicare |
$3,490.63
|
| Rate for Payer: Meridian Medicaid |
$2,005.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,665.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,014.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,087.40
|
| Rate for Payer: PACE Medicare |
$3,316.10
|
| Rate for Payer: PACE SWMI |
$3,490.63
|
| Rate for Payer: PHP Commercial |
$3,839.69
|
| Rate for Payer: PHP Medicaid |
$1,909.37
|
| Rate for Payer: PHP Medicare Advantage |
$3,490.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,909.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,305.33
|
| Rate for Payer: Priority Health Medicare |
$3,490.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,578.88
|
| Rate for Payer: Railroad Medicare Medicare |
$3,490.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,196.36
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.35
|
| Rate for Payer: VA VA |
$3,490.63
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.50 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: ASR ASR |
$92.15
|
| Rate for Payer: BCBS Trust/PPO |
$73.65
|
| Rate for Payer: BCN Commercial |
$73.65
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$89.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Healthscope Commercial |
$95.00
|
| Rate for Payer: Healthscope Whirlpool |
$92.15
|
| Rate for Payer: Mclaren Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.60
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.03 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare |
$21.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: ASR ASR |
$92.15
|
| Rate for Payer: BCBS Complete |
$12.63
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$73.65
|
| Rate for Payer: BCN Commercial |
$73.65
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$89.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$95.00
|
| Rate for Payer: Healthscope Whirlpool |
$92.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.99
|
| Rate for Payer: Mclaren Commercial |
$85.50
|
| Rate for Payer: Mclaren Medicaid |
$12.03
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Medicaid |
$12.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$24.19
|
| Rate for Payer: PHP Medicaid |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.45
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health Narrow Network |
$67.45
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.60
|
| Rate for Payer: UHC Medicare Advantage |
$22.65
|
| Rate for Payer: VA VA |
$21.99
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$28,917.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,566.80 |
| Max. Negotiated Rate |
$28,917.00 |
| Rate for Payer: Aetna Commercial |
$26,025.30
|
| Rate for Payer: ASR ASR |
$28,049.49
|
| Rate for Payer: BCBS Complete |
$11,566.80
|
| Rate for Payer: BCBS Trust/PPO |
$22,419.35
|
| Rate for Payer: BCN Commercial |
$22,419.35
|
| Rate for Payer: Cash Price |
$23,133.60
|
| Rate for Payer: Cofinity Commercial |
$27,181.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,133.60
|
| Rate for Payer: Healthscope Commercial |
$28,917.00
|
| Rate for Payer: Healthscope Whirlpool |
$28,049.49
|
| Rate for Payer: Mclaren Commercial |
$26,025.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,579.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,241.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,314.47
|
| Rate for Payer: Priority Health Narrow Network |
$20,531.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,446.96
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$28,917.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,241.90 |
| Max. Negotiated Rate |
$28,917.00 |
| Rate for Payer: Aetna Commercial |
$26,025.30
|
| Rate for Payer: ASR ASR |
$28,049.49
|
| Rate for Payer: BCBS Trust/PPO |
$22,419.35
|
| Rate for Payer: BCN Commercial |
$22,419.35
|
| Rate for Payer: Cash Price |
$23,133.60
|
| Rate for Payer: Cofinity Commercial |
$27,181.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,133.60
|
| Rate for Payer: Healthscope Commercial |
$28,917.00
|
| Rate for Payer: Healthscope Whirlpool |
$28,049.49
|
| Rate for Payer: Mclaren Commercial |
$26,025.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,579.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,241.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,446.96
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$9,660.80
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,762.56 |
| Max. Negotiated Rate |
$9,660.80 |
| Rate for Payer: Aetna Commercial |
$8,694.72
|
| Rate for Payer: ASR ASR |
$9,370.98
|
| Rate for Payer: BCBS Trust/PPO |
$7,490.02
|
| Rate for Payer: BCN Commercial |
$7,490.02
|
| Rate for Payer: Cash Price |
$7,728.64
|
| Rate for Payer: Cofinity Commercial |
$9,081.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,728.64
|
| Rate for Payer: Healthscope Commercial |
$9,660.80
|
| Rate for Payer: Healthscope Whirlpool |
$9,370.98
|
| Rate for Payer: Mclaren Commercial |
$8,694.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,501.50
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$9,660.80
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,584.36 |
| Max. Negotiated Rate |
$9,660.80 |
| Rate for Payer: Aetna Commercial |
$8,694.72
|
| Rate for Payer: Aetna Medicare |
$2,896.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: ASR ASR |
$9,370.98
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$7,490.02
|
| Rate for Payer: BCN Commercial |
$7,490.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$7,728.64
|
| Rate for Payer: Cash Price |
$7,728.64
|
| Rate for Payer: Cofinity Commercial |
$9,081.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,728.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$9,660.80
|
| Rate for Payer: Healthscope Whirlpool |
$9,370.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,896.46
|
| Rate for Payer: Mclaren Commercial |
$8,694.72
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.68
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$3,186.11
|
| Rate for Payer: PHP Medicaid |
$1,584.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,791.33
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$6,859.17
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,501.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: VA VA |
$2,896.46
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.71
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$8.57
|
| Rate for Payer: BCBS Trust/PPO |
$77.53
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: BCN Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.57
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.57
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Mclaren Medicare |
$8.57
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.86
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: PACE Medicare |
$8.14
|
| Rate for Payer: PACE SWMI |
$8.57
|
| Rate for Payer: PHP Commercial |
$9.43
|
| Rate for Payer: PHP Medicaid |
$4.69
|
| Rate for Payer: PHP Medicare Advantage |
$8.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.80
|
| Rate for Payer: Priority Health Medicare |
$8.57
|
| Rate for Payer: Priority Health Narrow Network |
$9.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
| Rate for Payer: UHC Medicare Advantage |
$8.83
|
| Rate for Payer: VA VA |
$8.57
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.53
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC LEGIONELLA
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.79
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC LEGIONELLA AG
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.79
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC LEGIONELLA AG
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.79
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$107.60 |
| Rate for Payer: Aetna Commercial |
$96.84
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$104.37
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$83.42
|
| Rate for Payer: BCN Commercial |
$83.42
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$107.60
|
| Rate for Payer: Healthscope Whirlpool |
$104.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$96.84
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.92
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$76.40
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.69
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$75.32 |
| Max. Negotiated Rate |
$107.60 |
| Rate for Payer: Aetna Commercial |
$96.84
|
| Rate for Payer: ASR ASR |
$104.37
|
| Rate for Payer: BCBS Trust/PPO |
$83.42
|
| Rate for Payer: BCN Commercial |
$83.42
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Healthscope Commercial |
$107.60
|
| Rate for Payer: Healthscope Whirlpool |
$104.37
|
| Rate for Payer: Mclaren Commercial |
$96.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.69
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| 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 |
$118.73
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$94.90
|
| Rate for Payer: BCN Commercial |
$94.90
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Healthscope Whirlpool |
$118.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$110.16
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| 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 |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.38
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$86.90
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.71
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$85.68 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| Rate for Payer: ASR ASR |
$118.73
|
| Rate for Payer: BCBS Trust/PPO |
$94.90
|
| Rate for Payer: BCN Commercial |
$94.90
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Healthscope Whirlpool |
$118.73
|
| Rate for Payer: Mclaren Commercial |
$110.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.71
|
|
|
HC LEGIONELLA PNEUMOPHILA AB
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200301
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$77.99 |
| Rate for Payer: Aetna Commercial |
$43.20
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: ASR ASR |
$46.56
|
| Rate for Payer: BCBS Complete |
$8.79
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$37.21
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$48.00
|
| Rate for Payer: Healthscope Whirlpool |
$46.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$43.20
|
| Rate for Payer: Mclaren Medicaid |
$8.37
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Medicaid |
$8.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicaid |
$8.37
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.99
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$62.39
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.24
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
|
