|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: Aetna Medicare |
$17.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Complete |
$10.33
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$124.05
|
| Rate for Payer: BCN Commercial |
$124.05
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$160.00
|
| Rate for Payer: Healthscope Whirlpool |
$155.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.98
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Mclaren Medicaid |
$9.84
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Medicaid |
$10.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$19.78
|
| Rate for Payer: PHP Medicaid |
$9.84
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.60
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$113.60
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: VA VA |
$17.98
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$213.50 |
| Max. Negotiated Rate |
$305.00 |
| Rate for Payer: Aetna Commercial |
$274.50
|
| Rate for Payer: ASR ASR |
$295.85
|
| Rate for Payer: BCBS Trust/PPO |
$236.47
|
| Rate for Payer: BCN Commercial |
$236.47
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$286.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.00
|
| Rate for Payer: Healthscope Commercial |
$305.00
|
| Rate for Payer: Healthscope Whirlpool |
$295.85
|
| Rate for Payer: Mclaren Commercial |
$274.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$259.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.40
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$305.00 |
| Rate for Payer: Aetna Commercial |
$274.50
|
| Rate for Payer: Aetna Medicare |
$48.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: ASR ASR |
$295.85
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$236.47
|
| Rate for Payer: BCCCP Commercial |
$71.93
|
| Rate for Payer: BCN Commercial |
$236.47
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$286.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$305.00
|
| Rate for Payer: Healthscope Whirlpool |
$295.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$48.17
|
| Rate for Payer: Mclaren Commercial |
$274.50
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$259.25
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$52.99
|
| Rate for Payer: PHP Medicaid |
$26.35
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.97
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$124.78
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.40
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: VA VA |
$48.17
|
|
|
HC LVAD INSERTION
|
Facility
|
IP
|
$3,160.43
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,212.30 |
| Max. Negotiated Rate |
$3,160.43 |
| Rate for Payer: Aetna Commercial |
$2,844.39
|
| Rate for Payer: ASR ASR |
$3,065.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.28
|
| Rate for Payer: BCN Commercial |
$2,450.28
|
| Rate for Payer: Cash Price |
$2,528.34
|
| Rate for Payer: Cofinity Commercial |
$2,970.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$3,160.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,065.62
|
| Rate for Payer: Mclaren Commercial |
$2,844.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,686.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,212.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,781.18
|
|
|
HC LVAD INSERTION
|
Facility
|
OP
|
$3,160.43
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$3,160.43 |
| Rate for Payer: Aetna Commercial |
$2,844.39
|
| Rate for Payer: ASR ASR |
$3,065.62
|
| Rate for Payer: BCBS Complete |
$1,264.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.28
|
| Rate for Payer: BCN Commercial |
$2,450.28
|
| Rate for Payer: Cash Price |
$2,528.34
|
| Rate for Payer: Cash Price |
$2,528.34
|
| Rate for Payer: Cofinity Commercial |
$2,970.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$3,160.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,065.62
|
| Rate for Payer: Mclaren Commercial |
$2,844.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,686.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,212.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,781.18
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
IP
|
$2,777.25
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,944.08 |
| Max. Negotiated Rate |
$2,777.25 |
| Rate for Payer: Aetna Commercial |
$2,499.52
|
| Rate for Payer: ASR ASR |
$2,693.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,153.20
|
| Rate for Payer: BCN Commercial |
$2,153.20
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cofinity Commercial |
$2,610.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.80
|
| Rate for Payer: Healthscope Commercial |
$2,777.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,693.93
|
| Rate for Payer: Mclaren Commercial |
$2,499.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,360.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,944.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,443.98
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
OP
|
$2,777.25
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$343.17 |
| Max. Negotiated Rate |
$2,777.25 |
| Rate for Payer: Aetna Commercial |
$2,499.52
|
| Rate for Payer: Aetna Medicare |
$627.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$784.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$784.21
|
| Rate for Payer: ASR ASR |
$2,693.93
|
| Rate for Payer: BCBS Complete |
$360.36
|
| Rate for Payer: BCBS MAPPO |
$627.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,153.20
|
| Rate for Payer: BCN Commercial |
$2,153.20
|
| Rate for Payer: BCN Medicare Advantage |
$627.37
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cofinity Commercial |
$2,610.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.37
|
| Rate for Payer: Healthscope Commercial |
$2,777.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,693.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$627.37
|
| Rate for Payer: Mclaren Commercial |
$2,499.52
|
| Rate for Payer: Mclaren Medicaid |
$343.17
|
| Rate for Payer: Mclaren Medicare |
$627.37
|
| Rate for Payer: Meridian Medicaid |
$360.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,360.66
|
| Rate for Payer: PACE Medicare |
$596.00
|
| Rate for Payer: PACE SWMI |
$627.37
|
| Rate for Payer: PHP Commercial |
$690.11
|
| Rate for Payer: PHP Medicaid |
$343.17
|
| Rate for Payer: PHP Medicare Advantage |
$627.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,944.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,345.32
|
| Rate for Payer: Priority Health Medicare |
$627.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,076.26
|
| Rate for Payer: Railroad Medicare Medicare |
$627.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,443.98
|
| Rate for Payer: UHC Medicare Advantage |
$646.19
|
| Rate for Payer: VA VA |
$627.37
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
OP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$2,156.91 |
| Rate for Payer: Aetna Commercial |
$1,941.22
|
| Rate for Payer: Aetna Medicare |
$440.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$550.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$550.81
|
| Rate for Payer: ASR ASR |
$2,092.20
|
| Rate for Payer: BCBS Complete |
$253.11
|
| Rate for Payer: BCBS MAPPO |
$440.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.25
|
| Rate for Payer: BCN Commercial |
$1,672.25
|
| Rate for Payer: BCN Medicare Advantage |
$440.65
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$2,027.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.65
|
| Rate for Payer: Healthscope Commercial |
$2,156.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,092.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$440.65
|
| Rate for Payer: Mclaren Commercial |
$1,941.22
|
| Rate for Payer: Mclaren Medicaid |
$241.04
|
| Rate for Payer: Mclaren Medicare |
$440.65
|
| Rate for Payer: Meridian Medicaid |
$253.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,833.37
|
| Rate for Payer: PACE Medicare |
$418.62
|
| Rate for Payer: PACE SWMI |
$440.65
|
| Rate for Payer: PHP Commercial |
$484.72
|
| Rate for Payer: PHP Medicaid |
$241.04
|
| Rate for Payer: PHP Medicare Advantage |
$440.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$815.81
|
| Rate for Payer: Priority Health Medicare |
$440.65
|
| Rate for Payer: Priority Health Narrow Network |
$652.65
|
| Rate for Payer: Railroad Medicare Medicare |
$440.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,898.08
|
| Rate for Payer: UHC Medicare Advantage |
$453.87
|
| Rate for Payer: VA VA |
$440.65
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
IP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,509.84 |
| Max. Negotiated Rate |
$2,156.91 |
| Rate for Payer: Aetna Commercial |
$1,941.22
|
| Rate for Payer: ASR ASR |
$2,092.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.25
|
| Rate for Payer: BCN Commercial |
$1,672.25
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$2,027.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Healthscope Commercial |
$2,156.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,092.20
|
| Rate for Payer: Mclaren Commercial |
$1,941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,833.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,898.08
|
|
|
HC LV LEAD PLACEMENT
|
Facility
|
OP
|
$8,832.18
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,532.87 |
| Max. Negotiated Rate |
$8,832.18 |
| Rate for Payer: Aetna Commercial |
$7,948.96
|
| Rate for Payer: ASR ASR |
$8,567.21
|
| Rate for Payer: BCBS Complete |
$3,532.87
|
| Rate for Payer: BCBS Trust/PPO |
$6,847.59
|
| Rate for Payer: BCN Commercial |
$6,847.59
|
| Rate for Payer: Cash Price |
$7,065.74
|
| Rate for Payer: Cofinity Commercial |
$8,302.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,065.74
|
| Rate for Payer: Healthscope Commercial |
$8,832.18
|
| Rate for Payer: Healthscope Whirlpool |
$8,567.21
|
| Rate for Payer: Mclaren Commercial |
$7,948.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,507.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,182.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,037.28
|
| Rate for Payer: Priority Health Narrow Network |
$6,270.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,772.32
|
|
|
HC LV LEAD PLACEMENT
|
Facility
|
IP
|
$8,832.18
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,182.53 |
| Max. Negotiated Rate |
$8,832.18 |
| Rate for Payer: Aetna Commercial |
$7,948.96
|
| Rate for Payer: ASR ASR |
$8,567.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,847.59
|
| Rate for Payer: BCN Commercial |
$6,847.59
|
| Rate for Payer: Cash Price |
$7,065.74
|
| Rate for Payer: Cofinity Commercial |
$8,302.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,065.74
|
| Rate for Payer: Healthscope Commercial |
$8,832.18
|
| Rate for Payer: Healthscope Whirlpool |
$8,567.21
|
| Rate for Payer: Mclaren Commercial |
$7,948.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,507.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,182.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,772.32
|
|
|
HC LV LEAD REPOSITIONING
|
Facility
|
OP
|
$3,518.07
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
36100071
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$3,166.26
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$3,412.53
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,727.56
|
| Rate for Payer: BCN Commercial |
$2,727.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,814.46
|
| Rate for Payer: Cash Price |
$2,814.46
|
| Rate for Payer: Cofinity Commercial |
$3,306.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,814.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,518.07
|
| Rate for Payer: Healthscope Whirlpool |
$3,412.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,166.26
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,990.36
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,462.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,201.44
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,497.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,095.90
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC LV LEAD REPOSITIONING
|
Facility
|
IP
|
$3,518.07
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
36100071
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,462.65 |
| Max. Negotiated Rate |
$3,518.07 |
| Rate for Payer: Aetna Commercial |
$3,166.26
|
| Rate for Payer: ASR ASR |
$3,412.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,727.56
|
| Rate for Payer: BCN Commercial |
$2,727.56
|
| Rate for Payer: Cash Price |
$2,814.46
|
| Rate for Payer: Cofinity Commercial |
$3,306.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,814.46
|
| Rate for Payer: Healthscope Commercial |
$3,518.07
|
| Rate for Payer: Healthscope Whirlpool |
$3,412.53
|
| Rate for Payer: Mclaren Commercial |
$3,166.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,990.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,462.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,095.90
|
|
|
HC LW / LASSO / ORBITER CATHETER
|
Facility
|
IP
|
$4,698.41
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,288.89 |
| Max. Negotiated Rate |
$4,698.41 |
| Rate for Payer: Aetna Commercial |
$4,228.57
|
| Rate for Payer: ASR ASR |
$4,557.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,642.68
|
| Rate for Payer: BCN Commercial |
$3,642.68
|
| Rate for Payer: Cash Price |
$3,758.73
|
| Rate for Payer: Cofinity Commercial |
$4,416.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,758.73
|
| Rate for Payer: Healthscope Commercial |
$4,698.41
|
| Rate for Payer: Healthscope Whirlpool |
$4,557.46
|
| Rate for Payer: Mclaren Commercial |
$4,228.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,993.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,288.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,134.60
|
|
|
HC LW / LASSO / ORBITER CATHETER
|
Facility
|
OP
|
$4,698.41
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,879.36 |
| Max. Negotiated Rate |
$4,698.41 |
| Rate for Payer: Aetna Commercial |
$4,228.57
|
| Rate for Payer: ASR ASR |
$4,557.46
|
| Rate for Payer: BCBS Complete |
$1,879.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,642.68
|
| Rate for Payer: BCN Commercial |
$3,642.68
|
| Rate for Payer: Cash Price |
$3,758.73
|
| Rate for Payer: Cofinity Commercial |
$4,416.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,758.73
|
| Rate for Payer: Healthscope Commercial |
$4,698.41
|
| Rate for Payer: Healthscope Whirlpool |
$4,557.46
|
| Rate for Payer: Mclaren Commercial |
$4,228.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,993.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,288.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,275.55
|
| Rate for Payer: Priority Health Narrow Network |
$3,335.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,134.60
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
IP
|
$33.66
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.56 |
| Max. Negotiated Rate |
$33.66 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: ASR ASR |
$32.65
|
| Rate for Payer: BCBS Trust/PPO |
$26.10
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$31.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.65
|
| Rate for Payer: Mclaren Commercial |
$30.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.62
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
OP
|
$33.66
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$33.66 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: Aetna Medicare |
$15.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.36
|
| Rate for Payer: ASR ASR |
$32.65
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS MAPPO |
$15.49
|
| Rate for Payer: BCBS Trust/PPO |
$26.10
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: BCN Medicare Advantage |
$15.49
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$31.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.49
|
| Rate for Payer: Mclaren Commercial |
$30.29
|
| Rate for Payer: Mclaren Medicaid |
$8.47
|
| Rate for Payer: Mclaren Medicare |
$15.49
|
| Rate for Payer: Meridian Medicaid |
$8.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.61
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.49
|
| Rate for Payer: PHP Commercial |
$17.04
|
| Rate for Payer: PHP Medicaid |
$8.47
|
| Rate for Payer: PHP Medicare Advantage |
$15.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.81
|
| Rate for Payer: Priority Health Medicare |
$15.49
|
| Rate for Payer: Priority Health Narrow Network |
$25.45
|
| Rate for Payer: Railroad Medicare Medicare |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.62
|
| Rate for Payer: UHC Medicare Advantage |
$15.95
|
| Rate for Payer: VA VA |
$15.49
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.30 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: ASR ASR |
$57.23
|
| Rate for Payer: BCBS Trust/PPO |
$45.74
|
| Rate for Payer: BCN Commercial |
$45.74
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$55.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Healthscope Commercial |
$59.00
|
| Rate for Payer: Healthscope Whirlpool |
$57.23
|
| Rate for Payer: Mclaren Commercial |
$53.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.92
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: Aetna Medicare |
$7.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.72
|
| Rate for Payer: ASR ASR |
$57.23
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS MAPPO |
$7.78
|
| Rate for Payer: BCBS Trust/PPO |
$45.74
|
| Rate for Payer: BCN Commercial |
$45.74
|
| Rate for Payer: BCN Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$55.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$59.00
|
| Rate for Payer: Healthscope Whirlpool |
$57.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.78
|
| Rate for Payer: Mclaren Commercial |
$53.10
|
| Rate for Payer: Mclaren Medicaid |
$4.26
|
| Rate for Payer: Mclaren Medicare |
$7.78
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.15
|
| Rate for Payer: PACE Medicare |
$7.39
|
| Rate for Payer: PACE SWMI |
$7.78
|
| Rate for Payer: PHP Commercial |
$8.56
|
| Rate for Payer: PHP Medicaid |
$4.26
|
| Rate for Payer: PHP Medicare Advantage |
$7.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.69
|
| Rate for Payer: Priority Health Medicare |
$7.78
|
| Rate for Payer: Priority Health Narrow Network |
$41.89
|
| Rate for Payer: Railroad Medicare Medicare |
$7.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.92
|
| Rate for Payer: UHC Medicare Advantage |
$8.01
|
| Rate for Payer: VA VA |
$7.78
|
|
|
HC LYME CSF COMPONENT 2
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.32 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$143.10
|
| Rate for Payer: Aetna Medicare |
$17.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: ASR ASR |
$154.23
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$123.27
|
| Rate for Payer: BCN Commercial |
$123.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$149.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$159.00
|
| Rate for Payer: Healthscope Whirlpool |
$154.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.03
|
| Rate for Payer: Mclaren Commercial |
$143.10
|
| Rate for Payer: Mclaren Medicaid |
$9.32
|
| Rate for Payer: Mclaren Medicare |
$17.03
|
| Rate for Payer: Meridian Medicaid |
$9.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.15
|
| Rate for Payer: PACE Medicare |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$18.73
|
| Rate for Payer: PHP Medicaid |
$9.32
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.92
|
| Rate for Payer: UHC Medicare Advantage |
$17.54
|
| Rate for Payer: VA VA |
$17.03
|
|
|
HC LYME CSF COMPONENT 2
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$143.10
|
| Rate for Payer: ASR ASR |
$154.23
|
| Rate for Payer: BCBS Trust/PPO |
$123.27
|
| Rate for Payer: BCN Commercial |
$123.27
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$149.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.20
|
| Rate for Payer: Healthscope Commercial |
$159.00
|
| Rate for Payer: Healthscope Whirlpool |
$154.23
|
| Rate for Payer: Mclaren Commercial |
$143.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.92
|
|
|
HC LYME CSF COMPONENT 3
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100670
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: Aetna Medicare |
$9.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: ASR ASR |
$84.39
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$67.45
|
| Rate for Payer: BCN Commercial |
$67.45
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$87.00
|
| Rate for Payer: Healthscope Whirlpool |
$84.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.30
|
| Rate for Payer: Mclaren Commercial |
$78.30
|
| Rate for Payer: Mclaren Medicaid |
$5.09
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$5.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.95
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$10.23
|
| Rate for Payer: PHP Medicaid |
$5.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.56
|
| Rate for Payer: UHC Medicare Advantage |
$9.58
|
| Rate for Payer: VA VA |
$9.30
|
|
|
HC LYME CSF COMPONENT 3
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100670
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.90 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: Aetna Commercial |
$78.30
|
| Rate for Payer: ASR ASR |
$84.39
|
| Rate for Payer: BCBS Trust/PPO |
$67.45
|
| Rate for Payer: BCN Commercial |
$67.45
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.60
|
| Rate for Payer: Healthscope Commercial |
$87.00
|
| Rate for Payer: Healthscope Whirlpool |
$84.39
|
| Rate for Payer: Mclaren Commercial |
$78.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.56
|
|
|
HC LYME CSF IGG AB INDEX
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$71.00 |
| Rate for Payer: Aetna Commercial |
$63.90
|
| Rate for Payer: ASR ASR |
$68.87
|
| Rate for Payer: BCBS Trust/PPO |
$55.05
|
| Rate for Payer: BCN Commercial |
$55.05
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$66.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.80
|
| Rate for Payer: Healthscope Commercial |
$71.00
|
| Rate for Payer: Healthscope Whirlpool |
$68.87
|
| Rate for Payer: Mclaren Commercial |
$63.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.48
|
|
|
HC LYME CSF IGG AB INDEX
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$71.00 |
| Rate for Payer: Aetna Commercial |
$63.90
|
| Rate for Payer: Aetna Medicare |
$4.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.19
|
| Rate for Payer: ASR ASR |
$68.87
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$4.95
|
| Rate for Payer: BCBS Trust/PPO |
$55.05
|
| Rate for Payer: BCN Commercial |
$55.05
|
| Rate for Payer: BCN Medicare Advantage |
$4.95
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$66.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.95
|
| Rate for Payer: Healthscope Commercial |
$71.00
|
| Rate for Payer: Healthscope Whirlpool |
$68.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.95
|
| Rate for Payer: Mclaren Commercial |
$63.90
|
| Rate for Payer: Mclaren Medicaid |
$2.71
|
| Rate for Payer: Mclaren Medicare |
$4.95
|
| Rate for Payer: Meridian Medicaid |
$2.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.35
|
| Rate for Payer: PACE Medicare |
$4.70
|
| Rate for Payer: PACE SWMI |
$4.95
|
| Rate for Payer: PHP Commercial |
$5.44
|
| Rate for Payer: PHP Medicaid |
$2.71
|
| Rate for Payer: PHP Medicare Advantage |
$4.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.91
|
| Rate for Payer: Priority Health Medicare |
$4.95
|
| Rate for Payer: Priority Health Narrow Network |
$12.73
|
| Rate for Payer: Railroad Medicare Medicare |
$4.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$5.10
|
| Rate for Payer: VA VA |
$4.95
|
|
