|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
OP
|
$231.81
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$231.81 |
| Rate for Payer: Aetna Commercial |
$208.63
|
| Rate for Payer: Aetna Medicare |
$82.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.24
|
| Rate for Payer: ASR ASR |
$224.86
|
| Rate for Payer: ASR Commercial |
$224.86
|
| Rate for Payer: BCBS Complete |
$46.48
|
| Rate for Payer: BCBS MAPPO |
$82.59
|
| Rate for Payer: BCBS Trust/PPO |
$189.83
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: BCN Medicare Advantage |
$82.59
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.59
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$82.59
|
| Rate for Payer: Mclaren Commercial |
$208.63
|
| Rate for Payer: Mclaren Medicaid |
$44.27
|
| Rate for Payer: Mclaren Medicare |
$82.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.72
|
| Rate for Payer: Meridian Medicaid |
$46.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.04
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: PACE Medicare |
$78.46
|
| Rate for Payer: PACE SWMI |
$82.59
|
| Rate for Payer: PHP Commercial |
$90.85
|
| Rate for Payer: PHP Medicaid |
$44.27
|
| Rate for Payer: PHP Medicare Advantage |
$82.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$82.59
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$82.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.59
|
| Rate for Payer: UHC Exchange |
$128.01
|
| Rate for Payer: UHC Medicare Advantage |
$82.59
|
| Rate for Payer: UHCCP DNSP |
$82.59
|
| Rate for Payer: UHCCP Medicaid |
$44.27
|
| Rate for Payer: VA VA |
$82.59
|
|
|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
IP
|
$231.81
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$150.68 |
| Max. Negotiated Rate |
$231.81 |
| Rate for Payer: Aetna Commercial |
$208.63
|
| Rate for Payer: ASR ASR |
$224.86
|
| Rate for Payer: ASR Commercial |
$224.86
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.45
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Mclaren Commercial |
$208.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.04
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.99
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
IP
|
$231.81
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$150.68 |
| Max. Negotiated Rate |
$231.81 |
| Rate for Payer: Aetna Commercial |
$208.63
|
| Rate for Payer: ASR ASR |
$224.86
|
| Rate for Payer: ASR Commercial |
$224.86
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.45
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Mclaren Commercial |
$208.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.04
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.99
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
OP
|
$231.81
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$231.81 |
| Rate for Payer: Aetna Commercial |
$208.63
|
| Rate for Payer: Aetna Medicare |
$82.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.24
|
| Rate for Payer: ASR ASR |
$224.86
|
| Rate for Payer: ASR Commercial |
$224.86
|
| Rate for Payer: BCBS Complete |
$46.48
|
| Rate for Payer: BCBS MAPPO |
$82.59
|
| Rate for Payer: BCBS Trust/PPO |
$189.83
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: BCN Medicare Advantage |
$82.59
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.59
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$82.59
|
| Rate for Payer: Mclaren Commercial |
$208.63
|
| Rate for Payer: Mclaren Medicaid |
$44.27
|
| Rate for Payer: Mclaren Medicare |
$82.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.72
|
| Rate for Payer: Meridian Medicaid |
$46.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.04
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: PACE Medicare |
$78.46
|
| Rate for Payer: PACE SWMI |
$82.59
|
| Rate for Payer: PHP Commercial |
$90.85
|
| Rate for Payer: PHP Medicaid |
$44.27
|
| Rate for Payer: PHP Medicare Advantage |
$82.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$82.59
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$82.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.59
|
| Rate for Payer: UHC Exchange |
$128.01
|
| Rate for Payer: UHC Medicare Advantage |
$82.59
|
| Rate for Payer: UHCCP DNSP |
$82.59
|
| Rate for Payer: UHCCP Medicaid |
$44.27
|
| Rate for Payer: VA VA |
$82.59
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
OP
|
$231.81
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$231.81 |
| Rate for Payer: Aetna Commercial |
$208.63
|
| Rate for Payer: Aetna Medicare |
$82.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.24
|
| Rate for Payer: ASR ASR |
$224.86
|
| Rate for Payer: ASR Commercial |
$224.86
|
| Rate for Payer: BCBS Complete |
$46.48
|
| Rate for Payer: BCBS MAPPO |
$82.59
|
| Rate for Payer: BCBS Trust/PPO |
$189.83
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: BCN Medicare Advantage |
$82.59
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.59
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$82.59
|
| Rate for Payer: Mclaren Commercial |
$208.63
|
| Rate for Payer: Mclaren Medicaid |
$44.27
|
| Rate for Payer: Mclaren Medicare |
$82.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.72
|
| Rate for Payer: Meridian Medicaid |
$46.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.04
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: PACE Medicare |
$78.46
|
| Rate for Payer: PACE SWMI |
$82.59
|
| Rate for Payer: PHP Commercial |
$90.85
|
| Rate for Payer: PHP Medicaid |
$44.27
|
| Rate for Payer: PHP Medicare Advantage |
$82.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$82.59
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$82.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.59
|
| Rate for Payer: UHC Exchange |
$128.01
|
| Rate for Payer: UHC Medicare Advantage |
$82.59
|
| Rate for Payer: UHCCP DNSP |
$82.59
|
| Rate for Payer: UHCCP Medicaid |
$44.27
|
| Rate for Payer: VA VA |
$82.59
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
IP
|
$231.81
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$150.68 |
| Max. Negotiated Rate |
$231.81 |
| Rate for Payer: Aetna Commercial |
$208.63
|
| Rate for Payer: ASR ASR |
$224.86
|
| Rate for Payer: ASR Commercial |
$224.86
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: Cash Price |
$185.45
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.45
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Mclaren Commercial |
$208.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.04
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.99
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
OP
|
$96.59
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$128.01 |
| Rate for Payer: Aetna Commercial |
$86.93
|
| Rate for Payer: Aetna Medicare |
$82.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.24
|
| Rate for Payer: ASR ASR |
$93.69
|
| Rate for Payer: ASR Commercial |
$93.69
|
| Rate for Payer: BCBS Complete |
$46.48
|
| Rate for Payer: BCBS MAPPO |
$82.59
|
| Rate for Payer: BCBS Trust/PPO |
$79.10
|
| Rate for Payer: BCN Commercial |
$74.89
|
| Rate for Payer: BCN Medicare Advantage |
$82.59
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$90.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.59
|
| Rate for Payer: Healthscope Commercial |
$96.59
|
| Rate for Payer: Healthscope Whirlpool |
$93.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$82.59
|
| Rate for Payer: Mclaren Commercial |
$86.93
|
| Rate for Payer: Mclaren Medicaid |
$44.27
|
| Rate for Payer: Mclaren Medicare |
$82.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.72
|
| Rate for Payer: Meridian Medicaid |
$46.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.10
|
| Rate for Payer: Nomi Health Commercial |
$79.20
|
| Rate for Payer: PACE Medicare |
$78.46
|
| Rate for Payer: PACE SWMI |
$82.59
|
| Rate for Payer: PHP Commercial |
$90.85
|
| Rate for Payer: PHP Medicaid |
$44.27
|
| Rate for Payer: PHP Medicare Advantage |
$82.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$82.59
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$82.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.59
|
| Rate for Payer: UHC Exchange |
$128.01
|
| Rate for Payer: UHC Medicare Advantage |
$82.59
|
| Rate for Payer: UHCCP DNSP |
$82.59
|
| Rate for Payer: UHCCP Medicaid |
$44.27
|
| Rate for Payer: VA VA |
$82.59
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
IP
|
$96.59
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$62.78 |
| Max. Negotiated Rate |
$96.59 |
| Rate for Payer: Aetna Commercial |
$86.93
|
| Rate for Payer: ASR ASR |
$93.69
|
| Rate for Payer: ASR Commercial |
$93.69
|
| Rate for Payer: BCBS Trust/PPO |
$78.71
|
| Rate for Payer: BCN Commercial |
$74.89
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$90.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.27
|
| Rate for Payer: Healthscope Commercial |
$96.59
|
| Rate for Payer: Healthscope Whirlpool |
$93.69
|
| Rate for Payer: Mclaren Commercial |
$86.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.10
|
| Rate for Payer: Nomi Health Commercial |
$79.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.00
|
|
|
HC FROZEN SECTION
|
Facility
|
IP
|
$127.03
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.57 |
| Max. Negotiated Rate |
$127.03 |
| Rate for Payer: Aetna Commercial |
$114.33
|
| Rate for Payer: ASR ASR |
$123.22
|
| Rate for Payer: ASR Commercial |
$123.22
|
| Rate for Payer: BCBS Trust/PPO |
$103.52
|
| Rate for Payer: BCN Commercial |
$98.49
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cofinity Commercial |
$119.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.62
|
| Rate for Payer: Healthscope Commercial |
$127.03
|
| Rate for Payer: Healthscope Whirlpool |
$123.22
|
| Rate for Payer: Mclaren Commercial |
$114.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.79
|
|
|
HC FROZEN SECTION
|
Facility
|
OP
|
$127.03
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.12 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$114.33
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$123.22
|
| Rate for Payer: ASR Commercial |
$123.22
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$104.02
|
| Rate for Payer: BCCCP Commercial |
$94.70
|
| Rate for Payer: BCN Commercial |
$98.49
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cofinity Commercial |
$119.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$127.03
|
| Rate for Payer: Healthscope Whirlpool |
$123.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$114.33
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$104.16
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.15
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$64.12
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC FRUCTOSAMINE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$16.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.95
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$16.76
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$16.76
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.76
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.76
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Mclaren Medicare |
$16.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.60
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$15.92
|
| Rate for Payer: PACE SWMI |
$16.76
|
| Rate for Payer: PHP Commercial |
$18.44
|
| Rate for Payer: PHP Medicaid |
$8.98
|
| Rate for Payer: PHP Medicare Advantage |
$16.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$16.76
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$16.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.76
|
| Rate for Payer: UHC Exchange |
$25.98
|
| Rate for Payer: UHC Medicare Advantage |
$16.76
|
| Rate for Payer: UHCCP DNSP |
$16.76
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$16.76
|
|
|
HC FRUCTOSAMINE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
OP
|
$96.80
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$96.80 |
| Rate for Payer: Aetna Commercial |
$87.12
|
| Rate for Payer: Aetna Medicare |
$17.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: ASR ASR |
$93.90
|
| Rate for Payer: ASR Commercial |
$93.90
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$75.05
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cofinity Commercial |
$90.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$96.80
|
| Rate for Payer: Healthscope Whirlpool |
$93.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.34
|
| Rate for Payer: Mclaren Commercial |
$87.12
|
| Rate for Payer: Mclaren Medicaid |
$9.29
|
| Rate for Payer: Mclaren Medicare |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.28
|
| Rate for Payer: Nomi Health Commercial |
$79.38
|
| Rate for Payer: PACE Medicare |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicaid |
$9.29
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.82
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow Network |
$67.86
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.34
|
| Rate for Payer: UHC Exchange |
$26.88
|
| Rate for Payer: UHC Medicare Advantage |
$17.34
|
| Rate for Payer: UHCCP DNSP |
$17.34
|
| Rate for Payer: UHCCP Medicaid |
$9.29
|
| Rate for Payer: VA VA |
$17.34
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
IP
|
$96.80
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.92 |
| Max. Negotiated Rate |
$96.80 |
| Rate for Payer: Aetna Commercial |
$87.12
|
| Rate for Payer: ASR ASR |
$93.90
|
| Rate for Payer: ASR Commercial |
$93.90
|
| Rate for Payer: BCBS Trust/PPO |
$78.88
|
| Rate for Payer: BCN Commercial |
$75.05
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cofinity Commercial |
$90.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.44
|
| Rate for Payer: Healthscope Commercial |
$96.80
|
| Rate for Payer: Healthscope Whirlpool |
$93.90
|
| Rate for Payer: Mclaren Commercial |
$87.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.28
|
| Rate for Payer: Nomi Health Commercial |
$79.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.18
|
|
|
HC F/U EP STUDY
|
Facility
|
OP
|
$5,613.56
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,648.81 |
| Max. Negotiated Rate |
$11,523.74 |
| Rate for Payer: Aetna Commercial |
$5,052.20
|
| Rate for Payer: Aetna Medicare |
$7,434.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,293.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,293.34
|
| Rate for Payer: ASR ASR |
$5,445.15
|
| Rate for Payer: ASR Commercial |
$5,445.15
|
| Rate for Payer: BCBS Complete |
$4,184.23
|
| Rate for Payer: BCBS MAPPO |
$7,434.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,596.94
|
| Rate for Payer: BCN Commercial |
$4,352.19
|
| Rate for Payer: BCN Medicare Advantage |
$7,434.67
|
| Rate for Payer: Cash Price |
$4,490.85
|
| Rate for Payer: Cash Price |
$4,490.85
|
| Rate for Payer: Cofinity Commercial |
$5,276.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,490.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,434.67
|
| Rate for Payer: Healthscope Commercial |
$5,613.56
|
| Rate for Payer: Healthscope Whirlpool |
$5,445.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,434.67
|
| Rate for Payer: Mclaren Commercial |
$5,052.20
|
| Rate for Payer: Mclaren Medicaid |
$3,984.98
|
| Rate for Payer: Mclaren Medicare |
$7,434.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,806.40
|
| Rate for Payer: Meridian Medicaid |
$4,184.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,549.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,771.53
|
| Rate for Payer: Nomi Health Commercial |
$4,603.12
|
| Rate for Payer: PACE Medicare |
$7,062.94
|
| Rate for Payer: PACE SWMI |
$7,434.67
|
| Rate for Payer: PHP Commercial |
$8,178.14
|
| Rate for Payer: PHP Medicaid |
$3,984.98
|
| Rate for Payer: PHP Medicare Advantage |
$7,434.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,984.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,648.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,918.60
|
| Rate for Payer: Priority Health Medicare |
$7,434.67
|
| Rate for Payer: Priority Health Narrow Network |
$3,935.11
|
| Rate for Payer: Railroad Medicare Medicare |
$7,434.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,939.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,434.67
|
| Rate for Payer: UHC Exchange |
$11,523.74
|
| Rate for Payer: UHC Medicare Advantage |
$7,434.67
|
| Rate for Payer: UHCCP DNSP |
$7,434.67
|
| Rate for Payer: UHCCP Medicaid |
$3,984.98
|
| Rate for Payer: VA VA |
$7,434.67
|
|
|
HC F/U EP STUDY
|
Facility
|
IP
|
$5,613.56
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,648.81 |
| Max. Negotiated Rate |
$5,613.56 |
| Rate for Payer: Aetna Commercial |
$5,052.20
|
| Rate for Payer: ASR ASR |
$5,445.15
|
| Rate for Payer: ASR Commercial |
$5,445.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,574.49
|
| Rate for Payer: BCN Commercial |
$4,352.19
|
| Rate for Payer: Cash Price |
$4,490.85
|
| Rate for Payer: Cofinity Commercial |
$5,276.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,490.85
|
| Rate for Payer: Healthscope Commercial |
$5,613.56
|
| Rate for Payer: Healthscope Whirlpool |
$5,445.15
|
| Rate for Payer: Mclaren Commercial |
$5,052.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,771.53
|
| Rate for Payer: Nomi Health Commercial |
$4,603.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,648.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,939.93
|
|
|
HC FUNC BACK EVAL
|
Facility
|
OP
|
$125.65
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$50.26 |
| Max. Negotiated Rate |
$125.65 |
| Rate for Payer: Aetna Commercial |
$113.08
|
| Rate for Payer: Aetna Medicare |
$62.82
|
| Rate for Payer: ASR ASR |
$121.88
|
| Rate for Payer: ASR Commercial |
$121.88
|
| Rate for Payer: BCBS Complete |
$50.26
|
| Rate for Payer: BCBS Trust/PPO |
$102.89
|
| Rate for Payer: BCN Commercial |
$97.42
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$118.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.52
|
| Rate for Payer: Healthscope Commercial |
$125.65
|
| Rate for Payer: Healthscope Whirlpool |
$121.88
|
| Rate for Payer: Mclaren Commercial |
$113.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.80
|
| Rate for Payer: Nomi Health Commercial |
$103.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.09
|
| Rate for Payer: Priority Health Narrow Network |
$88.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.57
|
|
|
HC FUNC BACK EVAL
|
Facility
|
IP
|
$125.65
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$81.67 |
| Max. Negotiated Rate |
$125.65 |
| Rate for Payer: Aetna Commercial |
$113.08
|
| Rate for Payer: ASR ASR |
$121.88
|
| Rate for Payer: ASR Commercial |
$121.88
|
| Rate for Payer: BCBS Trust/PPO |
$102.39
|
| Rate for Payer: BCN Commercial |
$97.42
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$118.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.52
|
| Rate for Payer: Healthscope Commercial |
$125.65
|
| Rate for Payer: Healthscope Whirlpool |
$121.88
|
| Rate for Payer: Mclaren Commercial |
$113.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.80
|
| Rate for Payer: Nomi Health Commercial |
$103.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.57
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
IP
|
$67.42
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.82 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$60.68
|
| Rate for Payer: ASR ASR |
$65.40
|
| Rate for Payer: ASR Commercial |
$65.40
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$52.27
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$63.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Healthscope Whirlpool |
$65.40
|
| Rate for Payer: Mclaren Commercial |
$60.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.33
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
OP
|
$67.42
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$60.68
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$65.40
|
| Rate for Payer: ASR Commercial |
$65.40
|
| Rate for Payer: BCBS Complete |
$5.81
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.27
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$63.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Healthscope Whirlpool |
$65.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$60.68
|
| Rate for Payer: Mclaren Medicaid |
$5.53
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.53
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.07
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$47.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.32
|
| Rate for Payer: UHC Exchange |
$16.00
|
| Rate for Payer: UHC Medicare Advantage |
$10.32
|
| Rate for Payer: UHCCP DNSP |
$10.32
|
| Rate for Payer: UHCCP Medicaid |
$5.53
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
OP
|
$67.42
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$60.68
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$65.40
|
| Rate for Payer: ASR Commercial |
$65.40
|
| Rate for Payer: BCBS Complete |
$5.81
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.27
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$63.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Healthscope Whirlpool |
$65.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$60.68
|
| Rate for Payer: Mclaren Medicaid |
$5.53
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.53
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.07
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$47.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.32
|
| Rate for Payer: UHC Exchange |
$16.00
|
| Rate for Payer: UHC Medicare Advantage |
$10.32
|
| Rate for Payer: UHCCP DNSP |
$10.32
|
| Rate for Payer: UHCCP Medicaid |
$5.53
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
IP
|
$67.42
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.82 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$60.68
|
| Rate for Payer: ASR ASR |
$65.40
|
| Rate for Payer: ASR Commercial |
$65.40
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$52.27
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$63.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Healthscope Whirlpool |
$65.40
|
| Rate for Payer: Mclaren Commercial |
$60.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.33
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$65.88 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.78
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.42
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$7.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Medicaid |
$7.19
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.88
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$52.70
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.42
|
| Rate for Payer: UHC Exchange |
$20.80
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: UHCCP DNSP |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$13.42
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: ASR Commercial |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$33.25
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
|
