|
HC HEART CATH PACK
|
Facility
|
IP
|
$528.75
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$396.56 |
| Max. Negotiated Rate |
$528.75 |
| Rate for Payer: Aetna Commercial |
$475.88
|
| Rate for Payer: ASR ASR |
$512.89
|
| Rate for Payer: BCBS Trust/PPO |
$434.21
|
| Rate for Payer: BCN Commercial |
$434.21
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cofinity Commercial |
$497.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.00
|
| Rate for Payer: Healthscope Commercial |
$512.89
|
| Rate for Payer: Healthscope Whirlpool |
$528.75
|
| Rate for Payer: Mclaren Commercial |
$475.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.44
|
| Rate for Payer: Nomi Health Commercial |
$433.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.30
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$528.75
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$195.64 |
| Max. Negotiated Rate |
$528.75 |
| Rate for Payer: Aetna Commercial |
$475.88
|
| Rate for Payer: Aetna Medicare |
$195.64
|
| Rate for Payer: ASR ASR |
$512.89
|
| Rate for Payer: BCBS Complete |
$211.50
|
| Rate for Payer: BCBS Trust/PPO |
$435.95
|
| Rate for Payer: BCN Commercial |
$435.95
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cofinity Commercial |
$497.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.00
|
| Rate for Payer: Healthscope Commercial |
$512.89
|
| Rate for Payer: Healthscope Whirlpool |
$528.75
|
| Rate for Payer: Mclaren Commercial |
$475.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$423.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.44
|
| Rate for Payer: Nomi Health Commercial |
$433.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$463.29
|
| Rate for Payer: Priority Health Narrow Network |
$370.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.30
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,742.66
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$9,742.66 |
| Rate for Payer: Aetna Commercial |
$8,768.39
|
| Rate for Payer: Aetna Medicare |
$3,230.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: ASR ASR |
$9,450.38
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$8,032.82
|
| Rate for Payer: BCN Commercial |
$8,032.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$7,794.13
|
| Rate for Payer: Cash Price |
$7,794.13
|
| Rate for Payer: Cofinity Commercial |
$9,158.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,794.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$9,450.38
|
| Rate for Payer: Healthscope Whirlpool |
$9,742.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$8,768.39
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$1,774.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,281.26
|
| Rate for Payer: Nomi Health Commercial |
$7,988.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,306.99
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$3,553.30
|
| Rate for Payer: PHP Medicaid |
$1,731.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,536.52
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$6,829.60
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,573.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Exchange |
$5,006.92
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP DNSP |
$3,230.27
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: VA VA |
$3,230.27
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,742.66
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,306.99 |
| Max. Negotiated Rate |
$9,742.66 |
| Rate for Payer: Aetna Commercial |
$8,768.39
|
| Rate for Payer: ASR ASR |
$9,450.38
|
| Rate for Payer: BCBS Trust/PPO |
$8,000.67
|
| Rate for Payer: BCN Commercial |
$8,000.67
|
| Rate for Payer: Cash Price |
$7,794.13
|
| Rate for Payer: Cofinity Commercial |
$9,158.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,794.13
|
| Rate for Payer: Healthscope Commercial |
$9,450.38
|
| Rate for Payer: Healthscope Whirlpool |
$9,742.66
|
| Rate for Payer: Mclaren Commercial |
$8,768.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,281.26
|
| Rate for Payer: Nomi Health Commercial |
$7,988.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,306.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,573.54
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$33.94
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$33.94 |
| Rate for Payer: Aetna Commercial |
$30.55
|
| Rate for Payer: Aetna Medicare |
$12.56
|
| Rate for Payer: ASR ASR |
$32.92
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: BCBS Trust/PPO |
$27.98
|
| Rate for Payer: BCN Commercial |
$27.98
|
| Rate for Payer: Cash Price |
$27.15
|
| Rate for Payer: Cofinity Commercial |
$31.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.15
|
| Rate for Payer: Healthscope Commercial |
$32.92
|
| Rate for Payer: Healthscope Whirlpool |
$33.94
|
| Rate for Payer: Mclaren Commercial |
$30.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.85
|
| Rate for Payer: Nomi Health Commercial |
$27.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.74
|
| Rate for Payer: Priority Health Narrow Network |
$23.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.87
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$33.94
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.45 |
| Max. Negotiated Rate |
$33.94 |
| Rate for Payer: Aetna Commercial |
$30.55
|
| Rate for Payer: ASR ASR |
$32.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.87
|
| Rate for Payer: BCN Commercial |
$27.87
|
| Rate for Payer: Cash Price |
$27.15
|
| Rate for Payer: Cofinity Commercial |
$31.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.15
|
| Rate for Payer: Healthscope Commercial |
$32.92
|
| Rate for Payer: Healthscope Whirlpool |
$33.94
|
| Rate for Payer: Mclaren Commercial |
$30.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.85
|
| Rate for Payer: Nomi Health Commercial |
$27.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.87
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Trust/PPO |
$27.89
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$130.75 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$28.00
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Mclaren Medicaid |
$18.97
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.75
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$104.60
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
IP
|
$29.12
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$29.12 |
| Rate for Payer: Aetna Commercial |
$26.21
|
| Rate for Payer: ASR ASR |
$28.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.91
|
| Rate for Payer: BCN Commercial |
$23.91
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$28.25
|
| Rate for Payer: Healthscope Whirlpool |
$29.12
|
| Rate for Payer: Mclaren Commercial |
$26.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.75
|
| Rate for Payer: Nomi Health Commercial |
$23.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$29.12
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$29.12 |
| Rate for Payer: Aetna Commercial |
$26.21
|
| Rate for Payer: Aetna Medicare |
$16.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: ASR ASR |
$28.25
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$24.01
|
| Rate for Payer: BCN Commercial |
$24.01
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$28.25
|
| Rate for Payer: Healthscope Whirlpool |
$29.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.26
|
| Rate for Payer: Mclaren Commercial |
$26.21
|
| Rate for Payer: Mclaren Medicaid |
$16.26
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.75
|
| Rate for Payer: Nomi Health Commercial |
$23.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.84
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$17.89
|
| Rate for Payer: PHP Medicaid |
$8.72
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25.51
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health Narrow Network |
$20.41
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.26
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UHC Medicaid |
$8.50
|
| Rate for Payer: UHCCP DNSP |
$16.26
|
| Rate for Payer: UHCCP Medicaid |
$8.50
|
| Rate for Payer: VA VA |
$16.26
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$42.32
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$38.09
|
| Rate for Payer: ASR ASR |
$41.05
|
| Rate for Payer: BCBS Trust/PPO |
$34.75
|
| Rate for Payer: BCN Commercial |
$34.75
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cofinity Commercial |
$39.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.86
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Whirlpool |
$42.32
|
| Rate for Payer: Mclaren Commercial |
$38.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.97
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.24
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$42.32
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$38.09
|
| Rate for Payer: Aetna Medicare |
$23.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: ASR ASR |
$41.05
|
| Rate for Payer: BCBS Complete |
$12.98
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cofinity Commercial |
$39.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Whirlpool |
$42.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.64
|
| Rate for Payer: Mclaren Commercial |
$38.09
|
| Rate for Payer: Mclaren Medicaid |
$23.64
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$12.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.97
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.74
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$26.00
|
| Rate for Payer: PHP Medicaid |
$12.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.08
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow Network |
$29.67
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.64
|
| Rate for Payer: UHC Exchange |
$36.64
|
| Rate for Payer: UHC Medicaid |
$12.36
|
| Rate for Payer: UHCCP DNSP |
$23.64
|
| Rate for Payer: UHCCP Medicaid |
$12.36
|
| Rate for Payer: VA VA |
$23.64
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$21.67
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$21.67 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: ASR ASR |
$21.02
|
| Rate for Payer: BCBS Trust/PPO |
$17.80
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$20.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Healthscope Whirlpool |
$21.67
|
| Rate for Payer: Mclaren Commercial |
$19.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: Nomi Health Commercial |
$17.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.07
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$21.67
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare |
$12.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: ASR ASR |
$21.02
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$17.87
|
| Rate for Payer: BCN Commercial |
$17.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$20.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Healthscope Whirlpool |
$21.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.11
|
| Rate for Payer: Mclaren Commercial |
$19.50
|
| Rate for Payer: Mclaren Medicaid |
$12.11
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: Nomi Health Commercial |
$17.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.25
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$13.32
|
| Rate for Payer: PHP Medicaid |
$6.49
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.00
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health Narrow Network |
$36.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.11
|
| Rate for Payer: UHC Exchange |
$18.77
|
| Rate for Payer: UHC Medicaid |
$6.33
|
| Rate for Payer: UHCCP DNSP |
$12.11
|
| Rate for Payer: UHCCP Medicaid |
$6.33
|
| Rate for Payer: VA VA |
$12.11
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Trust/PPO |
$27.89
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$130.75 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$28.00
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Mclaren Medicaid |
$18.97
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.75
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$104.60
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$28.51
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$28.51 |
| Rate for Payer: Aetna Commercial |
$25.66
|
| Rate for Payer: Aetna Medicare |
$4.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.25
|
| Rate for Payer: ASR ASR |
$27.65
|
| Rate for Payer: BCBS Complete |
$2.31
|
| Rate for Payer: BCBS MAPPO |
$4.20
|
| Rate for Payer: BCBS Trust/PPO |
$23.51
|
| Rate for Payer: BCN Commercial |
$23.51
|
| Rate for Payer: BCN Medicare Advantage |
$4.20
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cofinity Commercial |
$26.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$27.65
|
| Rate for Payer: Healthscope Whirlpool |
$28.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.20
|
| Rate for Payer: Mclaren Commercial |
$25.66
|
| Rate for Payer: Mclaren Medicaid |
$4.20
|
| Rate for Payer: Mclaren Medicare |
$4.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.41
|
| Rate for Payer: Meridian Medicaid |
$2.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$23.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.38
|
| Rate for Payer: PACE Medicare |
$3.99
|
| Rate for Payer: PACE SWMI |
$4.20
|
| Rate for Payer: PHP Commercial |
$4.62
|
| Rate for Payer: PHP Medicaid |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$4.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24.98
|
| Rate for Payer: Priority Health Medicare |
$4.20
|
| Rate for Payer: Priority Health Narrow Network |
$19.99
|
| Rate for Payer: Railroad Medicare Medicare |
$4.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.20
|
| Rate for Payer: UHC Exchange |
$6.51
|
| Rate for Payer: UHC Medicaid |
$2.20
|
| Rate for Payer: UHCCP DNSP |
$4.20
|
| Rate for Payer: UHCCP Medicaid |
$2.20
|
| Rate for Payer: VA VA |
$4.20
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$28.51
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$28.51 |
| Rate for Payer: Aetna Commercial |
$25.66
|
| Rate for Payer: ASR ASR |
$27.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.41
|
| Rate for Payer: BCN Commercial |
$23.41
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cofinity Commercial |
$26.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.81
|
| Rate for Payer: Healthscope Commercial |
$27.65
|
| Rate for Payer: Healthscope Whirlpool |
$28.51
|
| Rate for Payer: Mclaren Commercial |
$25.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$23.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.09
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$7.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.82
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$7.86
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Medicare Advantage |
$7.86
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.86
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.86
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$7.86
|
| Rate for Payer: Mclaren Medicare |
$7.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.25
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$7.47
|
| Rate for Payer: PACE SWMI |
$7.86
|
| Rate for Payer: PHP Commercial |
$8.65
|
| Rate for Payer: PHP Medicaid |
$4.21
|
| Rate for Payer: PHP Medicare Advantage |
$7.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.25
|
| Rate for Payer: Priority Health Medicare |
$7.86
|
| Rate for Payer: Priority Health Narrow Network |
$18.60
|
| Rate for Payer: Railroad Medicare Medicare |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.86
|
| Rate for Payer: UHC Exchange |
$12.18
|
| Rate for Payer: UHC Medicaid |
$4.11
|
| Rate for Payer: UHCCP DNSP |
$7.86
|
| Rate for Payer: UHCCP Medicaid |
$4.11
|
| Rate for Payer: VA VA |
$7.86
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$162.22 |
| Rate for Payer: Aetna Commercial |
$100.75
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$108.59
|
| Rate for Payer: BCBS Complete |
$9.25
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$92.30
|
| Rate for Payer: BCN Commercial |
$92.30
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$105.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$108.59
|
| Rate for Payer: Healthscope Whirlpool |
$111.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$100.75
|
| Rate for Payer: Mclaren Medicaid |
$16.85
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$162.22
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$129.78
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.85
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHCCP DNSP |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.96 |
| Max. Negotiated Rate |
$111.95 |
| Rate for Payer: Aetna Commercial |
$100.75
|
| Rate for Payer: ASR ASR |
$108.59
|
| Rate for Payer: BCBS Trust/PPO |
$91.93
|
| Rate for Payer: BCN Commercial |
$91.93
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$105.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$108.59
|
| Rate for Payer: Healthscope Whirlpool |
$111.95
|
| Rate for Payer: Mclaren Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.52
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
OP
|
$159.18
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.23 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna Medicare |
$67.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.20
|
| Rate for Payer: ASR ASR |
$154.40
|
| Rate for Payer: BCBS Complete |
$36.99
|
| Rate for Payer: BCBS MAPPO |
$67.36
|
| Rate for Payer: BCBS Trust/PPO |
$131.24
|
| Rate for Payer: BCN Commercial |
$131.24
|
| Rate for Payer: BCN Medicare Advantage |
$67.36
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cofinity Commercial |
$149.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.36
|
| Rate for Payer: Healthscope Commercial |
$154.40
|
| Rate for Payer: Healthscope Whirlpool |
$159.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$67.36
|
| Rate for Payer: Mclaren Commercial |
$143.26
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$67.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.73
|
| Rate for Payer: Meridian Medicaid |
$36.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.30
|
| Rate for Payer: Nomi Health Commercial |
$130.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.39
|
| Rate for Payer: PACE Medicare |
$63.99
|
| Rate for Payer: PACE SWMI |
$67.36
|
| Rate for Payer: PHP Commercial |
$74.10
|
| Rate for Payer: PHP Medicaid |
$36.10
|
| Rate for Payer: PHP Medicare Advantage |
$67.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$139.47
|
| Rate for Payer: Priority Health Medicare |
$67.36
|
| Rate for Payer: Priority Health Narrow Network |
$111.59
|
| Rate for Payer: Railroad Medicare Medicare |
$67.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.36
|
| Rate for Payer: UHC Exchange |
$104.41
|
| Rate for Payer: UHC Medicaid |
$35.23
|
| Rate for Payer: UHCCP DNSP |
$67.36
|
| Rate for Payer: UHCCP Medicaid |
$35.23
|
| Rate for Payer: VA VA |
$67.36
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
IP
|
$159.18
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$119.39 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: ASR ASR |
$154.40
|
| Rate for Payer: BCBS Trust/PPO |
$130.72
|
| Rate for Payer: BCN Commercial |
$130.72
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cofinity Commercial |
$149.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.34
|
| Rate for Payer: Healthscope Commercial |
$154.40
|
| Rate for Payer: Healthscope Whirlpool |
$159.18
|
| Rate for Payer: Mclaren Commercial |
$143.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.30
|
| Rate for Payer: Nomi Health Commercial |
$130.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.08
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
