|
HC MYCOPLASMA GENITALIUM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$58.20
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$46.52
|
| Rate for Payer: BCN Commercial |
$46.52
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$60.00
|
| Rate for Payer: Healthscope Whirlpool |
$58.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.72
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$33.38
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.80
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: ASR ASR |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$46.52
|
| Rate for Payer: BCN Commercial |
$46.52
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$60.00
|
| Rate for Payer: Healthscope Whirlpool |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.80
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$143.06 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$138.77
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$110.91
|
| Rate for Payer: BCN Commercial |
$110.91
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$134.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Healthscope Whirlpool |
$138.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.72
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$33.38
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.89
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$143.06 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: ASR ASR |
$138.77
|
| Rate for Payer: BCBS Trust/PPO |
$110.91
|
| Rate for Payer: BCN Commercial |
$110.91
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$134.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Healthscope Whirlpool |
$138.77
|
| Rate for Payer: Mclaren Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.89
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$143.06 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: ASR ASR |
$138.77
|
| Rate for Payer: BCBS Trust/PPO |
$110.91
|
| Rate for Payer: BCN Commercial |
$110.91
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$134.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Healthscope Whirlpool |
$138.77
|
| Rate for Payer: Mclaren Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.89
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$143.06 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$138.77
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$110.91
|
| Rate for Payer: BCN Commercial |
$110.91
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$134.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Healthscope Whirlpool |
$138.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.72
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$33.38
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.89
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$143.06 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: ASR ASR |
$138.77
|
| Rate for Payer: BCBS Trust/PPO |
$110.91
|
| Rate for Payer: BCN Commercial |
$110.91
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$134.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Healthscope Whirlpool |
$138.77
|
| Rate for Payer: Mclaren Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.89
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$143.06 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$138.77
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$110.91
|
| Rate for Payer: BCN Commercial |
$110.91
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$134.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Healthscope Whirlpool |
$138.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.18
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$101.57
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.89
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
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 PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
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 PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$216.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$194.40
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$209.52
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$167.46
|
| Rate for Payer: BCN Commercial |
$167.46
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$203.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Healthscope Whirlpool |
$209.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$194.40
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.56
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$153.36
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.08
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$216.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$194.40
|
| Rate for Payer: ASR ASR |
$209.52
|
| Rate for Payer: BCBS Trust/PPO |
$167.46
|
| Rate for Payer: BCN Commercial |
$167.46
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$203.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.80
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Healthscope Whirlpool |
$209.52
|
| Rate for Payer: Mclaren Commercial |
$194.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.08
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$632.40
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$442.68 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Aetna Commercial |
$569.16
|
| Rate for Payer: ASR ASR |
$613.43
|
| Rate for Payer: BCBS Trust/PPO |
$490.30
|
| Rate for Payer: BCN Commercial |
$490.30
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cofinity Commercial |
$594.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.92
|
| Rate for Payer: Healthscope Commercial |
$632.40
|
| Rate for Payer: Healthscope Whirlpool |
$613.43
|
| Rate for Payer: Mclaren Commercial |
$569.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$556.51
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$632.40
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$95.94 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Aetna Commercial |
$569.16
|
| Rate for Payer: Aetna Medicare |
$175.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: ASR ASR |
$613.43
|
| Rate for Payer: BCBS Complete |
$100.75
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCBS Trust/PPO |
$490.30
|
| Rate for Payer: BCN Commercial |
$490.30
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cofinity Commercial |
$594.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$632.40
|
| Rate for Payer: Healthscope Whirlpool |
$613.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$175.40
|
| Rate for Payer: Mclaren Commercial |
$569.16
|
| Rate for Payer: Mclaren Medicaid |
$95.94
|
| Rate for Payer: Mclaren Medicare |
$175.40
|
| Rate for Payer: Meridian Medicaid |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.54
|
| Rate for Payer: PACE Medicare |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$192.94
|
| Rate for Payer: PHP Medicaid |
$95.94
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.68
|
| Rate for Payer: Priority Health Medicare |
$175.40
|
| Rate for Payer: Priority Health Narrow Network |
$150.14
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$556.51
|
| Rate for Payer: UHC Medicare Advantage |
$180.66
|
| Rate for Payer: VA VA |
$175.40
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.68 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| Rate for Payer: ASR ASR |
$118.73
|
| Rate for Payer: BCBS Trust/PPO |
$94.90
|
| Rate for Payer: BCN Commercial |
$94.90
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Healthscope Whirlpool |
$118.73
|
| Rate for Payer: Mclaren Commercial |
$110.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.71
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$118.73
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$94.90
|
| Rate for Payer: BCN Commercial |
$94.90
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Healthscope Whirlpool |
$118.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$110.16
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.38
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$86.90
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.71
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$75.13
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.18
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$68.80
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.83 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: BCBS Trust/PPO |
$75.13
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$171.36 |
| Rate for Payer: Aetna Commercial |
$154.22
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$166.22
|
| Rate for Payer: BCBS Complete |
$29.40
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$132.86
|
| Rate for Payer: BCN Commercial |
$132.86
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$161.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$171.36
|
| Rate for Payer: Healthscope Whirlpool |
$166.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$154.22
|
| Rate for Payer: Mclaren Medicaid |
$28.00
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Medicaid |
$29.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$145.66
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$28.00
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.94
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$121.67
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.80
|
| Rate for Payer: UHC Medicare Advantage |
$52.73
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$119.95 |
| Max. Negotiated Rate |
$171.36 |
| Rate for Payer: Aetna Commercial |
$154.22
|
| Rate for Payer: ASR ASR |
$166.22
|
| Rate for Payer: BCBS Trust/PPO |
$132.86
|
| Rate for Payer: BCN Commercial |
$132.86
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$161.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Healthscope Commercial |
$171.36
|
| Rate for Payer: Healthscope Whirlpool |
$166.22
|
| Rate for Payer: Mclaren Commercial |
$154.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$145.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.80
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.49 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$46.10
|
| Rate for Payer: ASR ASR |
$49.68
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS Trust/PPO |
$39.71
|
| Rate for Payer: BCN Commercial |
$39.71
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$51.22
|
| Rate for Payer: Healthscope Whirlpool |
$49.68
|
| Rate for Payer: Mclaren Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.07
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$51.22 |
| Rate for Payer: Aetna Commercial |
$46.10
|
| Rate for Payer: ASR ASR |
$49.68
|
| Rate for Payer: BCBS Trust/PPO |
$39.71
|
| Rate for Payer: BCN Commercial |
$39.71
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$51.22
|
| Rate for Payer: Healthscope Whirlpool |
$49.68
|
| Rate for Payer: Mclaren Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.07
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$51.22 |
| Rate for Payer: Aetna Commercial |
$46.10
|
| Rate for Payer: ASR ASR |
$49.68
|
| Rate for Payer: BCBS Trust/PPO |
$39.71
|
| Rate for Payer: BCN Commercial |
$39.71
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$51.22
|
| Rate for Payer: Healthscope Whirlpool |
$49.68
|
| Rate for Payer: Mclaren Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.07
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.49 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$46.10
|
| Rate for Payer: ASR ASR |
$49.68
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS Trust/PPO |
$39.71
|
| Rate for Payer: BCN Commercial |
$39.71
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$51.22
|
| Rate for Payer: Healthscope Whirlpool |
$49.68
|
| Rate for Payer: Mclaren Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.07
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.71 |
| Max. Negotiated Rate |
$29.58 |
| Rate for Payer: Aetna Commercial |
$26.62
|
| Rate for Payer: ASR ASR |
$28.69
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Commercial |
$22.93
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Healthscope Commercial |
$29.58
|
| Rate for Payer: Healthscope Whirlpool |
$28.69
|
| Rate for Payer: Mclaren Commercial |
$26.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.03
|
|
