|
HC LYME DISEASE ANTIBODY
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.32 |
| Max. Negotiated Rate |
$49.25 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| 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 |
$44.52
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.03
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| 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 |
$39.02
|
| 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 |
$32.13
|
| 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 |
$40.39
|
| Rate for Payer: UHC Medicare Advantage |
$17.54
|
| Rate for Payer: VA VA |
$17.03
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
IP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$178.24 |
| Max. Negotiated Rate |
$254.63 |
| Rate for Payer: Aetna Commercial |
$229.17
|
| Rate for Payer: ASR ASR |
$246.99
|
| Rate for Payer: BCBS Trust/PPO |
$197.41
|
| Rate for Payer: BCN Commercial |
$197.41
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$239.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Healthscope Commercial |
$254.63
|
| Rate for Payer: Healthscope Whirlpool |
$246.99
|
| Rate for Payer: Mclaren Commercial |
$229.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.07
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
OP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$254.63 |
| Rate for Payer: Aetna Commercial |
$229.17
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$246.99
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$197.41
|
| Rate for Payer: BCN Commercial |
$197.41
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$239.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$254.63
|
| Rate for Payer: Healthscope Whirlpool |
$246.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$229.17
|
| Rate for Payer: Mclaren Medicaid |
$26.82
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Medicaid |
$28.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.82
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.71
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$180.79
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.07
|
| Rate for Payer: UHC Medicare Advantage |
$50.50
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
IP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$192.22 |
| Max. Negotiated Rate |
$274.60 |
| Rate for Payer: Aetna Commercial |
$247.14
|
| Rate for Payer: ASR ASR |
$266.36
|
| Rate for Payer: BCBS Trust/PPO |
$212.90
|
| Rate for Payer: BCN Commercial |
$212.90
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$274.60
|
| Rate for Payer: Healthscope Whirlpool |
$266.36
|
| Rate for Payer: Mclaren Commercial |
$247.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.65
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
OP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$274.60 |
| Rate for Payer: Aetna Commercial |
$247.14
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$266.36
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$212.90
|
| Rate for Payer: BCN Commercial |
$212.90
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$274.60
|
| Rate for Payer: Healthscope Whirlpool |
$266.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$247.14
|
| Rate for Payer: Mclaren Medicaid |
$26.82
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Medicaid |
$28.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.82
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.89
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$194.97
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.65
|
| Rate for Payer: UHC Medicare Advantage |
$50.50
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$161.70 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$207.90
|
| Rate for Payer: ASR ASR |
$224.07
|
| Rate for Payer: BCBS Trust/PPO |
$179.09
|
| Rate for Payer: BCN Commercial |
$179.09
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.80
|
| Rate for Payer: Healthscope Commercial |
$231.00
|
| Rate for Payer: Healthscope Whirlpool |
$224.07
|
| Rate for Payer: Mclaren Commercial |
$207.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.28
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$207.90
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$224.07
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$179.09
|
| Rate for Payer: BCN Commercial |
$179.09
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$231.00
|
| Rate for Payer: Healthscope Whirlpool |
$224.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$207.90
|
| Rate for Payer: Mclaren Medicaid |
$26.82
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Medicaid |
$28.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.35
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.82
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.21
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$164.01
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.28
|
| Rate for Payer: UHC Medicare Advantage |
$50.50
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
OP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$254.63 |
| Rate for Payer: Aetna Commercial |
$229.17
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$246.99
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$197.41
|
| Rate for Payer: BCN Commercial |
$197.41
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$239.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$254.63
|
| Rate for Payer: Healthscope Whirlpool |
$246.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$229.17
|
| Rate for Payer: Mclaren Medicaid |
$26.82
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Medicaid |
$28.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.82
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.71
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$180.79
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.07
|
| Rate for Payer: UHC Medicare Advantage |
$50.50
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
IP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$178.24 |
| Max. Negotiated Rate |
$254.63 |
| Rate for Payer: Aetna Commercial |
$229.17
|
| Rate for Payer: ASR ASR |
$246.99
|
| Rate for Payer: BCBS Trust/PPO |
$197.41
|
| Rate for Payer: BCN Commercial |
$197.41
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$239.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Healthscope Commercial |
$254.63
|
| Rate for Payer: Healthscope Whirlpool |
$246.99
|
| Rate for Payer: Mclaren Commercial |
$229.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.07
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
OP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$274.60 |
| Rate for Payer: Aetna Commercial |
$247.14
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$266.36
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$212.90
|
| Rate for Payer: BCN Commercial |
$212.90
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$274.60
|
| Rate for Payer: Healthscope Whirlpool |
$266.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$247.14
|
| Rate for Payer: Mclaren Medicaid |
$26.82
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Medicaid |
$28.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.82
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.89
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$194.97
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.65
|
| Rate for Payer: UHC Medicare Advantage |
$50.50
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
IP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$192.22 |
| Max. Negotiated Rate |
$274.60 |
| Rate for Payer: Aetna Commercial |
$247.14
|
| Rate for Payer: ASR ASR |
$266.36
|
| Rate for Payer: BCBS Trust/PPO |
$212.90
|
| Rate for Payer: BCN Commercial |
$212.90
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$274.60
|
| Rate for Payer: Healthscope Whirlpool |
$266.36
|
| Rate for Payer: Mclaren Commercial |
$247.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.65
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$15.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.84
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$15.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.84
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.92
|
| Rate for Payer: Priority Health Narrow Network |
$10.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$660.00 |
| Rate for Payer: Aetna Commercial |
$594.00
|
| Rate for Payer: ASR ASR |
$640.20
|
| Rate for Payer: BCBS Complete |
$264.00
|
| Rate for Payer: BCBS Trust/PPO |
$511.70
|
| Rate for Payer: BCN Commercial |
$511.70
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$620.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.00
|
| Rate for Payer: Healthscope Commercial |
$660.00
|
| Rate for Payer: Healthscope Whirlpool |
$640.20
|
| Rate for Payer: Mclaren Commercial |
$594.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.60
|
| Rate for Payer: Priority Health Narrow Network |
$468.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.80
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$462.00 |
| Max. Negotiated Rate |
$660.00 |
| Rate for Payer: Aetna Commercial |
$594.00
|
| Rate for Payer: ASR ASR |
$640.20
|
| Rate for Payer: BCBS Trust/PPO |
$511.70
|
| Rate for Payer: BCN Commercial |
$511.70
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$620.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.00
|
| Rate for Payer: Healthscope Commercial |
$660.00
|
| Rate for Payer: Healthscope Whirlpool |
$640.20
|
| Rate for Payer: Mclaren Commercial |
$594.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.80
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
OP
|
$3,657.70
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$3,657.70 |
| Rate for Payer: Aetna Commercial |
$3,291.93
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$3,547.97
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,835.81
|
| Rate for Payer: BCN Commercial |
$2,835.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,926.16
|
| Rate for Payer: Cash Price |
$2,926.16
|
| Rate for Payer: Cofinity Commercial |
$3,438.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,926.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$3,657.70
|
| Rate for Payer: Healthscope Whirlpool |
$3,547.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$3,291.93
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,109.04
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,560.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,328.51
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,596.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,218.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
IP
|
$3,657.70
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,560.39 |
| Max. Negotiated Rate |
$3,657.70 |
| Rate for Payer: Aetna Commercial |
$3,291.93
|
| Rate for Payer: ASR ASR |
$3,547.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,835.81
|
| Rate for Payer: BCN Commercial |
$2,835.81
|
| Rate for Payer: Cash Price |
$2,926.16
|
| Rate for Payer: Cofinity Commercial |
$3,438.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,926.16
|
| Rate for Payer: Healthscope Commercial |
$3,657.70
|
| Rate for Payer: Healthscope Whirlpool |
$3,547.97
|
| Rate for Payer: Mclaren Commercial |
$3,291.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,109.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,560.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,218.78
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.52 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,215.00
|
| Rate for Payer: Aetna Medicare |
$489.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: ASR ASR |
$1,309.50
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.66
|
| Rate for Payer: BCN Commercial |
$1,046.66
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,269.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,309.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$489.06
|
| Rate for Payer: Mclaren Commercial |
$1,215.00
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$537.97
|
| Rate for Payer: PHP Medicaid |
$267.52
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.50
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$958.50
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,188.00
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$945.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,215.00
|
| Rate for Payer: ASR ASR |
$1,309.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.66
|
| Rate for Payer: BCN Commercial |
$1,046.66
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,269.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,309.50
|
| Rate for Payer: Mclaren Commercial |
$1,215.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,188.00
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
OP
|
$7,632.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.09 |
| Max. Negotiated Rate |
$7,632.00 |
| Rate for Payer: Aetna Commercial |
$6,868.80
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$7,403.04
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,917.09
|
| Rate for Payer: BCN Commercial |
$5,917.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cofinity Commercial |
$7,174.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,105.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,632.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,403.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$6,868.80
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,487.20
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,342.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,945.12
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$5,418.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,716.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
IP
|
$7,632.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,342.40 |
| Max. Negotiated Rate |
$7,632.00 |
| Rate for Payer: Aetna Commercial |
$6,868.80
|
| Rate for Payer: ASR ASR |
$7,403.04
|
| Rate for Payer: BCBS Trust/PPO |
$5,917.09
|
| Rate for Payer: BCN Commercial |
$5,917.09
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cofinity Commercial |
$7,174.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,105.60
|
| Rate for Payer: Healthscope Commercial |
$7,632.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,403.04
|
| Rate for Payer: Mclaren Commercial |
$6,868.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,487.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,342.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,716.16
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$56.96 |
| Rate for Payer: Aetna Commercial |
$39.65
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$42.74
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$34.16
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$41.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Whirlpool |
$42.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$39.65
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.45
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.96
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$45.57
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.77
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.84 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$39.65
|
| Rate for Payer: ASR ASR |
$42.74
|
| Rate for Payer: BCBS Trust/PPO |
$34.16
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$41.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Whirlpool |
$42.74
|
| Rate for Payer: Mclaren Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.77
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
IP
|
$43.20
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.24 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$38.88
|
| Rate for Payer: ASR ASR |
$41.90
|
| Rate for Payer: BCBS Trust/PPO |
$33.49
|
| Rate for Payer: BCN Commercial |
$33.49
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$40.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Healthscope Whirlpool |
$41.90
|
| Rate for Payer: Mclaren Commercial |
$38.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.02
|
|
