|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$905.11
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$678.83 |
| Max. Negotiated Rate |
$905.11 |
| Rate for Payer: Aetna Commercial |
$814.60
|
| Rate for Payer: ASR ASR |
$877.96
|
| Rate for Payer: BCBS Trust/PPO |
$743.28
|
| Rate for Payer: BCN Commercial |
$743.28
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Commercial |
$850.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Healthscope Commercial |
$877.96
|
| Rate for Payer: Healthscope Whirlpool |
$905.11
|
| Rate for Payer: Mclaren Commercial |
$814.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Nomi Health Commercial |
$742.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.50
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
IP
|
$733.08
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$549.81 |
| Max. Negotiated Rate |
$733.08 |
| Rate for Payer: Aetna Commercial |
$659.77
|
| Rate for Payer: ASR ASR |
$711.09
|
| Rate for Payer: BCBS Trust/PPO |
$602.01
|
| Rate for Payer: BCN Commercial |
$602.01
|
| Rate for Payer: Cash Price |
$586.46
|
| Rate for Payer: Cofinity Commercial |
$689.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.46
|
| Rate for Payer: Healthscope Commercial |
$711.09
|
| Rate for Payer: Healthscope Whirlpool |
$733.08
|
| Rate for Payer: Mclaren Commercial |
$659.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.12
|
| Rate for Payer: Nomi Health Commercial |
$601.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$549.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.11
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
OP
|
$733.08
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$217.98 |
| Max. Negotiated Rate |
$733.08 |
| Rate for Payer: Aetna Commercial |
$659.77
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$711.09
|
| Rate for Payer: BCBS Complete |
$228.90
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$604.42
|
| Rate for Payer: BCN Commercial |
$604.42
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$586.46
|
| Rate for Payer: Cash Price |
$586.46
|
| Rate for Payer: Cofinity Commercial |
$689.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$711.09
|
| Rate for Payer: Healthscope Whirlpool |
$733.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$659.77
|
| Rate for Payer: Mclaren Medicaid |
$416.78
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$228.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.12
|
| Rate for Payer: Nomi Health Commercial |
$601.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$549.81
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$223.39
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$642.32
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$513.89
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.78
|
| Rate for Payer: UHC Exchange |
$646.01
|
| Rate for Payer: UHC Medicaid |
$217.98
|
| Rate for Payer: UHCCP DNSP |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$217.98
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
IP
|
$905.11
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$678.83 |
| Max. Negotiated Rate |
$905.11 |
| Rate for Payer: Aetna Commercial |
$814.60
|
| Rate for Payer: ASR ASR |
$877.96
|
| Rate for Payer: BCBS Trust/PPO |
$743.28
|
| Rate for Payer: BCN Commercial |
$743.28
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Commercial |
$850.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Healthscope Commercial |
$877.96
|
| Rate for Payer: Healthscope Whirlpool |
$905.11
|
| Rate for Payer: Mclaren Commercial |
$814.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Nomi Health Commercial |
$742.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.50
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
OP
|
$905.11
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$814.60
|
| 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 |
$877.96
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$746.26
|
| Rate for Payer: BCN Commercial |
$746.26
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Commercial |
$850.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$877.96
|
| Rate for Payer: Healthscope Whirlpool |
$905.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$814.60
|
| 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 |
$769.34
|
| Rate for Payer: Nomi Health Commercial |
$742.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| 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 |
$793.06
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$634.48
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.50
|
| 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 GI REPLAC GJ TUBE W FLUOR
|
Facility
|
OP
|
$931.73
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$838.56
|
| 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 |
$903.78
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$768.21
|
| Rate for Payer: BCN Commercial |
$768.21
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cofinity Commercial |
$875.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$903.78
|
| Rate for Payer: Healthscope Whirlpool |
$931.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$838.56
|
| 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 |
$791.97
|
| Rate for Payer: Nomi Health Commercial |
$764.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.80
|
| 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 |
$816.38
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$653.14
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$819.92
|
| 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 GI REPLAC GJ TUBE W FLUOR
|
Facility
|
IP
|
$931.73
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.80 |
| Max. Negotiated Rate |
$931.73 |
| Rate for Payer: Aetna Commercial |
$838.56
|
| Rate for Payer: ASR ASR |
$903.78
|
| Rate for Payer: BCBS Trust/PPO |
$765.14
|
| Rate for Payer: BCN Commercial |
$765.14
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cofinity Commercial |
$875.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.38
|
| Rate for Payer: Healthscope Commercial |
$903.78
|
| Rate for Payer: Healthscope Whirlpool |
$931.73
|
| Rate for Payer: Mclaren Commercial |
$838.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$791.97
|
| Rate for Payer: Nomi Health Commercial |
$764.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$819.92
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
IP
|
$959.13
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$719.35 |
| Max. Negotiated Rate |
$959.13 |
| Rate for Payer: Aetna Commercial |
$863.22
|
| Rate for Payer: ASR ASR |
$930.36
|
| Rate for Payer: BCBS Trust/PPO |
$787.64
|
| Rate for Payer: BCN Commercial |
$787.64
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$901.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Healthscope Commercial |
$930.36
|
| Rate for Payer: Healthscope Whirlpool |
$959.13
|
| Rate for Payer: Mclaren Commercial |
$863.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$815.26
|
| Rate for Payer: Nomi Health Commercial |
$786.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$719.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.03
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
OP
|
$959.13
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$863.22
|
| 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 |
$930.36
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$790.80
|
| Rate for Payer: BCN Commercial |
$790.80
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$901.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$930.36
|
| Rate for Payer: Healthscope Whirlpool |
$959.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$863.22
|
| 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 |
$815.26
|
| Rate for Payer: Nomi Health Commercial |
$786.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$719.35
|
| 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 |
$1,055.61
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$844.49
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.03
|
| 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 GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
OP
|
$1,251.04
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$305.56 |
| Max. Negotiated Rate |
$1,400.77 |
| Rate for Payer: Aetna Commercial |
$1,125.94
|
| 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 |
$1,213.51
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.48
|
| Rate for Payer: BCN Commercial |
$1,031.48
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Commercial |
$1,175.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,213.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,251.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$1,125.94
|
| 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 |
$1,063.38
|
| Rate for Payer: Nomi Health Commercial |
$1,025.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| 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 |
$381.95
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$305.56
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,100.92
|
| 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 GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
IP
|
$1,251.04
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$938.28 |
| Max. Negotiated Rate |
$1,251.04 |
| Rate for Payer: Aetna Commercial |
$1,125.94
|
| Rate for Payer: ASR ASR |
$1,213.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,027.35
|
| Rate for Payer: BCN Commercial |
$1,027.35
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Commercial |
$1,175.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Healthscope Commercial |
$1,213.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,251.04
|
| Rate for Payer: Mclaren Commercial |
$1,125.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Nomi Health Commercial |
$1,025.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,100.92
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$30.62
|
| Rate for Payer: BCN Commercial |
$30.62
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$37.14 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Trust/PPO |
$30.50
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$28.98 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: ASR ASR |
$28.11
|
| Rate for Payer: BCBS Trust/PPO |
$23.80
|
| Rate for Payer: BCN Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.11
|
| Rate for Payer: Healthscope Whirlpool |
$28.98
|
| Rate for Payer: Mclaren Commercial |
$26.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.50
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$28.11
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$23.89
|
| Rate for Payer: BCN Commercial |
$23.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$28.11
|
| Rate for Payer: Healthscope Whirlpool |
$28.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$26.08
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.23 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.86
|
| Rate for Payer: BCN Commercial |
$41.86
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Healthscope Whirlpool |
$50.98
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Healthscope Whirlpool |
$50.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.67
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$35.74
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
IP
|
$315.42
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$236.56 |
| Max. Negotiated Rate |
$315.42 |
| Rate for Payer: Aetna Commercial |
$283.88
|
| Rate for Payer: ASR ASR |
$305.96
|
| Rate for Payer: BCBS Trust/PPO |
$259.02
|
| Rate for Payer: BCN Commercial |
$259.02
|
| Rate for Payer: Cash Price |
$252.34
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.34
|
| Rate for Payer: Healthscope Commercial |
$305.96
|
| Rate for Payer: Healthscope Whirlpool |
$315.42
|
| Rate for Payer: Mclaren Commercial |
$283.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.11
|
| Rate for Payer: Nomi Health Commercial |
$258.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.57
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
OP
|
$315.42
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.71 |
| Max. Negotiated Rate |
$315.42 |
| Rate for Payer: Aetna Commercial |
$283.88
|
| Rate for Payer: Aetna Medicare |
$116.71
|
| Rate for Payer: ASR ASR |
$305.96
|
| Rate for Payer: BCBS Complete |
$126.17
|
| Rate for Payer: BCBS Trust/PPO |
$260.06
|
| Rate for Payer: BCN Commercial |
$260.06
|
| Rate for Payer: Cash Price |
$252.34
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.34
|
| Rate for Payer: Healthscope Commercial |
$305.96
|
| Rate for Payer: Healthscope Whirlpool |
$315.42
|
| Rate for Payer: Mclaren Commercial |
$283.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.11
|
| Rate for Payer: Nomi Health Commercial |
$258.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.37
|
| Rate for Payer: Priority Health Narrow Network |
$221.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.57
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.35 |
| Max. Negotiated Rate |
$55.14 |
| Rate for Payer: Aetna Commercial |
$49.63
|
| Rate for Payer: ASR ASR |
$53.49
|
| Rate for Payer: BCBS Trust/PPO |
$45.28
|
| Rate for Payer: BCN Commercial |
$45.28
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$53.49
|
| Rate for Payer: Healthscope Whirlpool |
$55.14
|
| Rate for Payer: Mclaren Commercial |
$49.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.52
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$55.14 |
| Rate for Payer: Aetna Commercial |
$49.63
|
| Rate for Payer: Aetna Medicare |
$9.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.12
|
| Rate for Payer: ASR ASR |
$53.49
|
| Rate for Payer: BCBS Complete |
$5.33
|
| Rate for Payer: BCBS MAPPO |
$9.70
|
| Rate for Payer: BCBS Trust/PPO |
$45.46
|
| Rate for Payer: BCN Commercial |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.70
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.70
|
| Rate for Payer: Healthscope Commercial |
$53.49
|
| Rate for Payer: Healthscope Whirlpool |
$55.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.70
|
| Rate for Payer: Mclaren Commercial |
$49.63
|
| Rate for Payer: Mclaren Medicaid |
$9.70
|
| Rate for Payer: Mclaren Medicare |
$9.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.19
|
| Rate for Payer: Meridian Medicaid |
$5.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.35
|
| Rate for Payer: PACE Medicare |
$9.21
|
| Rate for Payer: PACE SWMI |
$9.70
|
| Rate for Payer: PHP Commercial |
$10.67
|
| Rate for Payer: PHP Medicaid |
$5.20
|
| Rate for Payer: PHP Medicare Advantage |
$9.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.08
|
| Rate for Payer: Priority Health Medicare |
$9.70
|
| Rate for Payer: Priority Health Narrow Network |
$44.07
|
| Rate for Payer: Railroad Medicare Medicare |
$9.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.70
|
| Rate for Payer: UHC Exchange |
$15.04
|
| Rate for Payer: UHC Medicaid |
$5.07
|
| Rate for Payer: UHCCP DNSP |
$9.70
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: VA VA |
$9.70
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$84.27 |
| Rate for Payer: Aetna Commercial |
$75.84
|
| Rate for Payer: ASR ASR |
$81.74
|
| Rate for Payer: BCBS Trust/PPO |
$69.20
|
| Rate for Payer: BCN Commercial |
$69.20
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$79.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$81.74
|
| Rate for Payer: Healthscope Whirlpool |
$84.27
|
| Rate for Payer: Mclaren Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.16
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.47 |
| Max. Negotiated Rate |
$121.04 |
| Rate for Payer: Aetna Commercial |
$75.84
|
| Rate for Payer: Aetna Medicare |
$14.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.86
|
| Rate for Payer: ASR ASR |
$81.74
|
| Rate for Payer: BCBS Complete |
$7.85
|
| Rate for Payer: BCBS MAPPO |
$14.29
|
| Rate for Payer: BCBS Trust/PPO |
$69.48
|
| Rate for Payer: BCN Commercial |
$69.48
|
| Rate for Payer: BCN Medicare Advantage |
$14.29
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$79.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.29
|
| Rate for Payer: Healthscope Commercial |
$81.74
|
| Rate for Payer: Healthscope Whirlpool |
$84.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.29
|
| Rate for Payer: Mclaren Commercial |
$75.84
|
| Rate for Payer: Mclaren Medicaid |
$14.29
|
| Rate for Payer: Mclaren Medicare |
$14.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.00
|
| Rate for Payer: Meridian Medicaid |
$7.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: PACE Medicare |
$13.58
|
| Rate for Payer: PACE SWMI |
$14.29
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: PHP Medicaid |
$7.66
|
| Rate for Payer: PHP Medicare Advantage |
$14.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$121.04
|
| Rate for Payer: Priority Health Medicare |
$14.29
|
| Rate for Payer: Priority Health Narrow Network |
$96.84
|
| Rate for Payer: Railroad Medicare Medicare |
$14.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.29
|
| Rate for Payer: UHC Exchange |
$22.15
|
| Rate for Payer: UHC Medicaid |
$7.47
|
| Rate for Payer: UHCCP DNSP |
$14.29
|
| Rate for Payer: UHCCP Medicaid |
$7.47
|
| Rate for Payer: VA VA |
$14.29
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
OP
|
$138.70
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$51.32 |
| Max. Negotiated Rate |
$138.70 |
| Rate for Payer: Aetna Commercial |
$124.83
|
| Rate for Payer: Aetna Medicare |
$51.32
|
| Rate for Payer: ASR ASR |
$134.54
|
| Rate for Payer: BCBS Complete |
$55.48
|
| Rate for Payer: BCBS Trust/PPO |
$114.36
|
| Rate for Payer: BCN Commercial |
$114.36
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cofinity Commercial |
$130.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$134.54
|
| Rate for Payer: Healthscope Whirlpool |
$138.70
|
| Rate for Payer: Mclaren Commercial |
$124.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.89
|
| Rate for Payer: Nomi Health Commercial |
$113.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$121.53
|
| Rate for Payer: Priority Health Narrow Network |
$97.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.06
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
IP
|
$138.70
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$104.03 |
| Max. Negotiated Rate |
$138.70 |
| Rate for Payer: Aetna Commercial |
$124.83
|
| Rate for Payer: ASR ASR |
$134.54
|
| Rate for Payer: BCBS Trust/PPO |
$113.90
|
| Rate for Payer: BCN Commercial |
$113.90
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cofinity Commercial |
$130.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$134.54
|
| Rate for Payer: Healthscope Whirlpool |
$138.70
|
| Rate for Payer: Mclaren Commercial |
$124.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.89
|
| Rate for Payer: Nomi Health Commercial |
$113.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.06
|
|
