|
HC ENDOVENT
|
Facility
|
IP
|
$4,805.54
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,123.60 |
| Max. Negotiated Rate |
$4,805.54 |
| Rate for Payer: Aetna Commercial |
$4,324.99
|
| Rate for Payer: ASR ASR |
$4,661.37
|
| Rate for Payer: ASR Commercial |
$4,661.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,916.03
|
| Rate for Payer: BCN Commercial |
$3,725.74
|
| Rate for Payer: Cash Price |
$3,844.43
|
| Rate for Payer: Cofinity Commercial |
$4,517.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,844.43
|
| Rate for Payer: Healthscope Commercial |
$4,805.54
|
| Rate for Payer: Healthscope Whirlpool |
$4,661.37
|
| Rate for Payer: Mclaren Commercial |
$4,324.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,084.71
|
| Rate for Payer: Nomi Health Commercial |
$3,940.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,123.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,228.88
|
|
|
HC ENDOVENT
|
Facility
|
OP
|
$4,805.54
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,922.22 |
| Max. Negotiated Rate |
$4,805.54 |
| Rate for Payer: Aetna Commercial |
$4,324.99
|
| Rate for Payer: Aetna Medicare |
$2,402.77
|
| Rate for Payer: ASR ASR |
$4,661.37
|
| Rate for Payer: ASR Commercial |
$4,661.37
|
| Rate for Payer: BCBS Complete |
$1,922.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,935.26
|
| Rate for Payer: BCN Commercial |
$3,725.74
|
| Rate for Payer: Cash Price |
$3,844.43
|
| Rate for Payer: Cofinity Commercial |
$4,517.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,844.43
|
| Rate for Payer: Healthscope Commercial |
$4,805.54
|
| Rate for Payer: Healthscope Whirlpool |
$4,661.37
|
| Rate for Payer: Mclaren Commercial |
$4,324.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,084.71
|
| Rate for Payer: Nomi Health Commercial |
$3,940.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,123.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,210.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,368.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,228.88
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
IP
|
$4,801.14
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,120.74 |
| Max. Negotiated Rate |
$4,801.14 |
| Rate for Payer: Aetna Commercial |
$4,321.03
|
| Rate for Payer: ASR ASR |
$4,657.11
|
| Rate for Payer: ASR Commercial |
$4,657.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,912.45
|
| Rate for Payer: BCN Commercial |
$3,722.32
|
| Rate for Payer: Cash Price |
$3,840.91
|
| Rate for Payer: Cofinity Commercial |
$4,513.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.91
|
| Rate for Payer: Healthscope Commercial |
$4,801.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,657.11
|
| Rate for Payer: Mclaren Commercial |
$4,321.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,080.97
|
| Rate for Payer: Nomi Health Commercial |
$3,936.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,120.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,225.00
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
OP
|
$4,801.14
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,920.46 |
| Max. Negotiated Rate |
$4,801.14 |
| Rate for Payer: Aetna Commercial |
$4,321.03
|
| Rate for Payer: Aetna Medicare |
$2,400.57
|
| Rate for Payer: ASR ASR |
$4,657.11
|
| Rate for Payer: ASR Commercial |
$4,657.11
|
| Rate for Payer: BCBS Complete |
$1,920.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,931.65
|
| Rate for Payer: BCN Commercial |
$3,722.32
|
| Rate for Payer: Cash Price |
$3,840.91
|
| Rate for Payer: Cofinity Commercial |
$4,513.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.91
|
| Rate for Payer: Healthscope Commercial |
$4,801.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,657.11
|
| Rate for Payer: Mclaren Commercial |
$4,321.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,080.97
|
| Rate for Payer: Nomi Health Commercial |
$3,936.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,120.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,206.76
|
| Rate for Payer: Priority Health Narrow Network |
$3,365.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,225.00
|
|
|
HC ENTEROVIRUS
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC ENTEROVIRUS
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| 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 |
$237.46
|
| Rate for Payer: ASR Commercial |
$237.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$200.47
|
| Rate for Payer: BCN Commercial |
$189.79
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$230.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$244.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$171.60
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$159.12 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: ASR ASR |
$237.46
|
| Rate for Payer: ASR Commercial |
$237.46
|
| Rate for Payer: BCBS Trust/PPO |
$199.49
|
| Rate for Payer: BCN Commercial |
$189.79
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$230.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$244.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.46
|
| Rate for Payer: Mclaren Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.42
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
OP
|
$205.73
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$205.73 |
| Rate for Payer: Aetna Commercial |
$185.16
|
| 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 |
$199.56
|
| Rate for Payer: ASR Commercial |
$199.56
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$168.47
|
| Rate for Payer: BCN Commercial |
$159.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$164.58
|
| Rate for Payer: Cash Price |
$164.58
|
| Rate for Payer: Cofinity Commercial |
$193.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$205.73
|
| Rate for Payer: Healthscope Whirlpool |
$199.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$185.16
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.87
|
| Rate for Payer: Nomi Health Commercial |
$168.70
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.26
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$144.22
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
IP
|
$205.73
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$133.72 |
| Max. Negotiated Rate |
$205.73 |
| Rate for Payer: Aetna Commercial |
$185.16
|
| Rate for Payer: ASR ASR |
$199.56
|
| Rate for Payer: ASR Commercial |
$199.56
|
| Rate for Payer: BCBS Trust/PPO |
$167.65
|
| Rate for Payer: BCN Commercial |
$159.50
|
| Rate for Payer: Cash Price |
$164.58
|
| Rate for Payer: Cofinity Commercial |
$193.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.58
|
| Rate for Payer: Healthscope Commercial |
$205.73
|
| Rate for Payer: Healthscope Whirlpool |
$199.56
|
| Rate for Payer: Mclaren Commercial |
$185.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.87
|
| Rate for Payer: Nomi Health Commercial |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.04
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| 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 |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$37.56 |
| Rate for Payer: Aetna Commercial |
$33.80
|
| 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 |
$36.43
|
| Rate for Payer: ASR Commercial |
$36.43
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$30.76
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$35.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$37.56
|
| Rate for Payer: Healthscope Whirlpool |
$36.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.62
|
| Rate for Payer: Mclaren Commercial |
$33.80
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| 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 |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$30.80
|
| 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 |
$4.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.91
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow Network |
$26.33
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Exchange |
$13.36
|
| Rate for Payer: UHC Medicare Advantage |
$8.62
|
| Rate for Payer: UHCCP DNSP |
$8.62
|
| Rate for Payer: UHCCP Medicaid |
$4.62
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$37.56 |
| Rate for Payer: Aetna Commercial |
$33.80
|
| Rate for Payer: ASR ASR |
$36.43
|
| Rate for Payer: ASR Commercial |
$36.43
|
| Rate for Payer: BCBS Trust/PPO |
$30.61
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$35.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$37.56
|
| Rate for Payer: Healthscope Whirlpool |
$36.43
|
| Rate for Payer: Mclaren Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$30.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.05
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.03 |
| Max. Negotiated Rate |
$29.27 |
| Rate for Payer: Aetna Commercial |
$26.34
|
| Rate for Payer: ASR ASR |
$28.39
|
| Rate for Payer: ASR Commercial |
$28.39
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$22.69
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$27.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Healthscope Commercial |
$29.27
|
| Rate for Payer: Healthscope Whirlpool |
$28.39
|
| Rate for Payer: Mclaren Commercial |
$26.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: Nomi Health Commercial |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.76
|
|
|
HC ENZYME DETECTION
|
Facility
|
OP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$29.27 |
| Rate for Payer: Aetna Commercial |
$26.34
|
| 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 |
$28.39
|
| Rate for Payer: ASR Commercial |
$28.39
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$23.97
|
| Rate for Payer: BCN Commercial |
$22.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$27.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$29.27
|
| Rate for Payer: Healthscope Whirlpool |
$28.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.75
|
| Rate for Payer: Mclaren Commercial |
$26.34
|
| Rate for Payer: Mclaren Medicaid |
$2.55
|
| 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 |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: Nomi Health Commercial |
$24.00
|
| 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 |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.65
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health Narrow Network |
$20.52
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Exchange |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$4.75
|
| Rate for Payer: UHCCP DNSP |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.55
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$107.41 |
| Max. Negotiated Rate |
$1,234.90 |
| Rate for Payer: Aetna Commercial |
$148.72
|
| Rate for Payer: Aetna Medicare |
$796.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: ASR ASR |
$160.28
|
| Rate for Payer: ASR Commercial |
$160.28
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCBS Trust/PPO |
$135.32
|
| Rate for Payer: BCN Commercial |
$128.11
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$155.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$165.24
|
| Rate for Payer: Healthscope Whirlpool |
$160.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$796.71
|
| Rate for Payer: Mclaren Commercial |
$148.72
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: Nomi Health Commercial |
$135.50
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$876.38
|
| Rate for Payer: PHP Medicaid |
$427.04
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.78
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health Narrow Network |
$115.83
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Exchange |
$1,234.90
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP DNSP |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$427.04
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$107.41 |
| Max. Negotiated Rate |
$165.24 |
| Rate for Payer: Aetna Commercial |
$148.72
|
| Rate for Payer: ASR ASR |
$160.28
|
| Rate for Payer: ASR Commercial |
$160.28
|
| Rate for Payer: BCBS Trust/PPO |
$134.65
|
| Rate for Payer: BCN Commercial |
$128.11
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$155.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Healthscope Commercial |
$165.24
|
| Rate for Payer: Healthscope Whirlpool |
$160.28
|
| Rate for Payer: Mclaren Commercial |
$148.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: Nomi Health Commercial |
$135.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.41
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$46.31 |
| Rate for Payer: Aetna Commercial |
$41.68
|
| Rate for Payer: ASR ASR |
$44.92
|
| Rate for Payer: ASR Commercial |
$44.92
|
| Rate for Payer: BCBS Trust/PPO |
$37.74
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$43.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$46.31
|
| Rate for Payer: Healthscope Whirlpool |
$44.92
|
| Rate for Payer: Mclaren Commercial |
$41.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.75
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$46.31 |
| Rate for Payer: Aetna Commercial |
$41.68
|
| 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 |
$44.92
|
| Rate for Payer: ASR Commercial |
$44.92
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$37.92
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$43.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$46.31
|
| Rate for Payer: Healthscope Whirlpool |
$44.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.79
|
| Rate for Payer: Mclaren Commercial |
$41.68
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| 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 |
$3.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| 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 |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.58
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health Narrow Network |
$32.46
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.79
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicare Advantage |
$5.79
|
| Rate for Payer: UHCCP DNSP |
$5.79
|
| Rate for Payer: UHCCP Medicaid |
$3.10
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.52 |
| Max. Negotiated Rate |
$31.31 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: ASR ASR |
$30.37
|
| Rate for Payer: ASR Commercial |
$30.37
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Healthscope Whirlpool |
$30.37
|
| Rate for Payer: Mclaren Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.43
|
| Rate for Payer: Priority Health Narrow Network |
$21.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.55
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.35 |
| Max. Negotiated Rate |
$31.31 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: ASR ASR |
$30.37
|
| Rate for Payer: ASR Commercial |
$30.37
|
| Rate for Payer: BCBS Trust/PPO |
$25.51
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Healthscope Whirlpool |
$30.37
|
| Rate for Payer: Mclaren Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.55
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$110.28 |
| Max. Negotiated Rate |
$275.71 |
| Rate for Payer: Aetna Commercial |
$248.14
|
| Rate for Payer: Aetna Medicare |
$137.85
|
| Rate for Payer: ASR ASR |
$267.44
|
| Rate for Payer: ASR Commercial |
$267.44
|
| Rate for Payer: BCBS Complete |
$110.28
|
| Rate for Payer: BCBS Trust/PPO |
$225.78
|
| Rate for Payer: BCN Commercial |
$213.76
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$275.71
|
| Rate for Payer: Healthscope Whirlpool |
$267.44
|
| Rate for Payer: Mclaren Commercial |
$248.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.58
|
| Rate for Payer: Priority Health Narrow Network |
$193.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.62
|
|
