|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC MUGWORT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MUGWORT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC MULBERRY IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MULBERRY IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
OP
|
$6.55
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$6.55 |
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: ASR ASR |
$6.35
|
| Rate for Payer: BCBS Complete |
$2.62
|
| Rate for Payer: BCBS Trust/PPO |
$5.08
|
| Rate for Payer: BCN Commercial |
$5.08
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cofinity Commercial |
$6.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.24
|
| Rate for Payer: Healthscope Commercial |
$6.55
|
| Rate for Payer: Healthscope Whirlpool |
$6.35
|
| Rate for Payer: Mclaren Commercial |
$5.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.96
|
| Rate for Payer: Priority Health Narrow Network |
$4.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.76
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$6.55
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$6.55 |
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: ASR ASR |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$5.08
|
| Rate for Payer: BCN Commercial |
$5.08
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cofinity Commercial |
$6.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.24
|
| Rate for Payer: Healthscope Commercial |
$6.55
|
| Rate for Payer: Healthscope Whirlpool |
$6.35
|
| Rate for Payer: Mclaren Commercial |
$5.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.76
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$629.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$440.30 |
| Max. Negotiated Rate |
$629.00 |
| Rate for Payer: Aetna Commercial |
$566.10
|
| Rate for Payer: ASR ASR |
$610.13
|
| Rate for Payer: BCBS Trust/PPO |
$487.66
|
| Rate for Payer: BCN Commercial |
$487.66
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$591.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.20
|
| Rate for Payer: Healthscope Commercial |
$629.00
|
| Rate for Payer: Healthscope Whirlpool |
$610.13
|
| Rate for Payer: Mclaren Commercial |
$566.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$534.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$553.52
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$629.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$629.00 |
| Rate for Payer: Aetna Commercial |
$566.10
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$610.13
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$487.66
|
| Rate for Payer: BCN Commercial |
$487.66
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$591.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$629.00
|
| Rate for Payer: Healthscope Whirlpool |
$610.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$566.10
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$534.65
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.39
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$446.59
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$553.52
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
OP
|
$1,234.00
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$1,234.00 |
| Rate for Payer: Aetna Commercial |
$1,110.60
|
| Rate for Payer: Aetna Commercial |
$752.76
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: ASR ASR |
$1,196.98
|
| Rate for Payer: ASR ASR |
$811.31
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$648.46
|
| Rate for Payer: BCBS Trust/PPO |
$956.72
|
| Rate for Payer: BCN Commercial |
$648.46
|
| Rate for Payer: BCN Commercial |
$956.72
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$1,159.96
|
| Rate for Payer: Cofinity Commercial |
$786.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$836.40
|
| Rate for Payer: Healthscope Commercial |
$1,234.00
|
| Rate for Payer: Healthscope Whirlpool |
$811.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$328.43
|
| Rate for Payer: Mclaren Commercial |
$1,110.60
|
| Rate for Payer: Mclaren Commercial |
$752.76
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$710.94
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Commercial |
$361.27
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicaid |
$179.65
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,122.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$761.12
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$593.84
|
| Rate for Payer: Priority Health Narrow Network |
$876.14
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,085.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.03
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
IP
|
$836.40
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$585.48 |
| Max. Negotiated Rate |
$836.40 |
| Rate for Payer: Aetna Commercial |
$752.76
|
| Rate for Payer: Aetna Commercial |
$1,110.60
|
| Rate for Payer: ASR ASR |
$1,196.98
|
| Rate for Payer: ASR ASR |
$811.31
|
| Rate for Payer: BCBS Trust/PPO |
$956.72
|
| Rate for Payer: BCBS Trust/PPO |
$648.46
|
| Rate for Payer: BCN Commercial |
$648.46
|
| Rate for Payer: BCN Commercial |
$956.72
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cofinity Commercial |
$786.22
|
| Rate for Payer: Cofinity Commercial |
$1,159.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.20
|
| Rate for Payer: Healthscope Commercial |
$1,234.00
|
| Rate for Payer: Healthscope Commercial |
$836.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.98
|
| Rate for Payer: Healthscope Whirlpool |
$811.31
|
| Rate for Payer: Mclaren Commercial |
$752.76
|
| Rate for Payer: Mclaren Commercial |
$1,110.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$710.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,085.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.03
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
IP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.06 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Aetna Commercial |
$108.07
|
| Rate for Payer: ASR ASR |
$116.48
|
| Rate for Payer: BCBS Trust/PPO |
$93.10
|
| Rate for Payer: BCN Commercial |
$93.10
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$112.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Healthscope Commercial |
$120.08
|
| Rate for Payer: Healthscope Whirlpool |
$116.48
|
| Rate for Payer: Mclaren Commercial |
$108.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.67
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
OP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Aetna Commercial |
$108.07
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$116.48
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$93.10
|
| Rate for Payer: BCN Commercial |
$93.10
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$112.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$120.08
|
| Rate for Payer: Healthscope Whirlpool |
$116.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$108.07
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.07
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$85.26
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.67
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC MUMPS AB IGG
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.30 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
|
|
HC MUMPS AB IGG
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: Aetna Medicare |
$13.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.05
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$7.14
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Medicaid |
$7.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: PHP Medicaid |
$7.14
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.10
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health Narrow Network |
$34.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: VA VA |
$13.05
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$68.40
|
| Rate for Payer: Aetna Medicare |
$13.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: ASR ASR |
$73.72
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$58.92
|
| Rate for Payer: BCN Commercial |
$58.92
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$71.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$76.00
|
| Rate for Payer: Healthscope Whirlpool |
$73.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.05
|
| Rate for Payer: Mclaren Commercial |
$68.40
|
| Rate for Payer: Mclaren Medicaid |
$7.14
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Medicaid |
$7.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.60
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: PHP Medicaid |
$7.14
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.10
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health Narrow Network |
$34.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.88
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: VA VA |
$13.05
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$68.40
|
| Rate for Payer: ASR ASR |
$73.72
|
| Rate for Payer: BCBS Trust/PPO |
$58.92
|
| Rate for Payer: BCN Commercial |
$58.92
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$71.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.80
|
| Rate for Payer: Healthscope Commercial |
$76.00
|
| Rate for Payer: Healthscope Whirlpool |
$73.72
|
| Rate for Payer: Mclaren Commercial |
$68.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.88
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Medicare |
$18.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.05
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$9.87
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$19.86
|
| Rate for Payer: PHP Medicaid |
$9.87
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.99
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$13.59
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: VA VA |
$18.05
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.99 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: BCBS Trust/PPO |
$16.61
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$55.93 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$16.61
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.24
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.93
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$44.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
IP
|
$20.33
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$20.33 |
| Rate for Payer: Aetna Commercial |
$18.30
|
| Rate for Payer: ASR ASR |
$19.72
|
| Rate for Payer: BCBS Trust/PPO |
$15.76
|
| Rate for Payer: BCN Commercial |
$15.76
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$19.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$20.33
|
| Rate for Payer: Healthscope Whirlpool |
$19.72
|
| Rate for Payer: Mclaren Commercial |
$18.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.89
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
OP
|
$20.33
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$55.93 |
| Rate for Payer: Aetna Commercial |
$18.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$19.72
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$15.76
|
| Rate for Payer: BCN Commercial |
$15.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$19.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$20.33
|
| Rate for Payer: Healthscope Whirlpool |
$19.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$18.30
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.28
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.24
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.93
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$44.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.89
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$75.32 |
| Max. Negotiated Rate |
$107.60 |
| Rate for Payer: Aetna Commercial |
$96.84
|
| Rate for Payer: ASR ASR |
$104.37
|
| Rate for Payer: BCBS Trust/PPO |
$83.42
|
| Rate for Payer: BCN Commercial |
$83.42
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Healthscope Commercial |
$107.60
|
| Rate for Payer: Healthscope Whirlpool |
$104.37
|
| Rate for Payer: Mclaren Commercial |
$96.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.69
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$107.60 |
| Rate for Payer: Aetna Commercial |
$96.84
|
| Rate for Payer: Aetna Medicare |
$15.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.24
|
| Rate for Payer: ASR ASR |
$104.37
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$15.39
|
| Rate for Payer: BCBS Trust/PPO |
$83.42
|
| Rate for Payer: BCN Commercial |
$83.42
|
| Rate for Payer: BCN Medicare Advantage |
$15.39
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$107.60
|
| Rate for Payer: Healthscope Whirlpool |
$104.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.39
|
| Rate for Payer: Mclaren Commercial |
$96.84
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Mclaren Medicare |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Medicare |
$14.62
|
| Rate for Payer: PACE SWMI |
$15.39
|
| Rate for Payer: PHP Commercial |
$16.93
|
| Rate for Payer: PHP Medicaid |
$8.42
|
| Rate for Payer: PHP Medicare Advantage |
$15.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.92
|
| Rate for Payer: Priority Health Medicare |
$15.39
|
| Rate for Payer: Priority Health Narrow Network |
$76.40
|
| Rate for Payer: Railroad Medicare Medicare |
$15.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.69
|
| Rate for Payer: UHC Medicare Advantage |
$15.85
|
| Rate for Payer: VA VA |
$15.39
|
|
