|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: Aetna Medicare |
$24.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.10
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: ASR Commercial |
$48.44
|
| Rate for Payer: BCBS Complete |
$13.55
|
| Rate for Payer: BCBS MAPPO |
$24.08
|
| Rate for Payer: BCBS Trust/PPO |
$40.90
|
| Rate for Payer: BCN Commercial |
$38.72
|
| Rate for Payer: BCN Medicare Advantage |
$24.08
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.08
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Healthscope Whirlpool |
$48.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.08
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.28
|
| Rate for Payer: Meridian Medicaid |
$13.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: PACE Medicare |
$22.88
|
| Rate for Payer: PACE SWMI |
$24.08
|
| Rate for Payer: PHP Commercial |
$26.49
|
| Rate for Payer: PHP Medicaid |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$24.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Medicare |
$24.08
|
| Rate for Payer: Priority Health Narrow Network |
$35.01
|
| Rate for Payer: Railroad Medicare Medicare |
$24.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.08
|
| Rate for Payer: UHC Exchange |
$37.32
|
| Rate for Payer: UHC Medicare Advantage |
$24.08
|
| Rate for Payer: UHCCP DNSP |
$24.08
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: VA VA |
$24.08
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$8.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.11
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$5.00
|
| Rate for Payer: BCBS MAPPO |
$8.89
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.89
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Mclaren Medicare |
$8.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.33
|
| Rate for Payer: Meridian Medicaid |
$5.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$8.45
|
| Rate for Payer: PACE SWMI |
$8.89
|
| Rate for Payer: PHP Commercial |
$9.78
|
| Rate for Payer: PHP Medicaid |
$4.77
|
| Rate for Payer: PHP Medicare Advantage |
$8.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.89
|
| Rate for Payer: UHC Exchange |
$13.78
|
| Rate for Payer: UHC Medicare Advantage |
$8.89
|
| Rate for Payer: UHCCP DNSP |
$8.89
|
| Rate for Payer: UHCCP Medicaid |
$4.77
|
| Rate for Payer: VA VA |
$8.89
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.90
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.52
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$14.87
|
| Rate for Payer: PHP Medicaid |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Exchange |
$20.96
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHCCP DNSP |
$13.52
|
| Rate for Payer: UHCCP Medicaid |
$7.25
|
| Rate for Payer: VA VA |
$13.52
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
IP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: ASR ASR |
$41.27
|
| Rate for Payer: ASR Commercial |
$41.27
|
| Rate for Payer: BCBS Trust/PPO |
$34.67
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$40.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Healthscope Commercial |
$42.55
|
| Rate for Payer: Healthscope Whirlpool |
$41.27
|
| Rate for Payer: Mclaren Commercial |
$38.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.44
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
OP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$41.27
|
| Rate for Payer: ASR Commercial |
$41.27
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$34.84
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$40.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$42.55
|
| Rate for Payer: Healthscope Whirlpool |
$41.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$38.30
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.28
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.83
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
IP
|
$436.97
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$284.03 |
| Max. Negotiated Rate |
$436.97 |
| Rate for Payer: Aetna Commercial |
$393.27
|
| Rate for Payer: ASR ASR |
$423.86
|
| Rate for Payer: ASR Commercial |
$423.86
|
| Rate for Payer: BCBS Trust/PPO |
$356.09
|
| Rate for Payer: BCN Commercial |
$338.78
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$410.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Healthscope Commercial |
$436.97
|
| Rate for Payer: Healthscope Whirlpool |
$423.86
|
| Rate for Payer: Mclaren Commercial |
$393.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.53
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
OP
|
$436.97
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.99 |
| Max. Negotiated Rate |
$436.97 |
| Rate for Payer: Aetna Commercial |
$393.27
|
| Rate for Payer: Aetna Medicare |
$257.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$321.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$321.81
|
| Rate for Payer: ASR ASR |
$423.86
|
| Rate for Payer: ASR Commercial |
$423.86
|
| Rate for Payer: BCBS Complete |
$144.89
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCBS Trust/PPO |
$357.83
|
| Rate for Payer: BCN Commercial |
$338.78
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$410.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$436.97
|
| Rate for Payer: Healthscope Whirlpool |
$423.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$257.45
|
| Rate for Payer: Mclaren Commercial |
$393.27
|
| Rate for Payer: Mclaren Medicaid |
$137.99
|
| Rate for Payer: Mclaren Medicare |
$257.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: Meridian Medicaid |
$144.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: PACE Medicare |
$244.58
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Commercial |
$283.19
|
| Rate for Payer: PHP Medicaid |
$137.99
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.87
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health Narrow Network |
$306.32
|
| Rate for Payer: Railroad Medicare Medicare |
$257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.45
|
| Rate for Payer: UHC Exchange |
$399.05
|
| Rate for Payer: UHC Medicare Advantage |
$257.45
|
| Rate for Payer: UHCCP DNSP |
$257.45
|
| Rate for Payer: UHCCP Medicaid |
$137.99
|
| Rate for Payer: VA VA |
$257.45
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
OP
|
$86.70
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$86.70 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$19.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: ASR ASR |
$84.10
|
| Rate for Payer: ASR Commercial |
$84.10
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$71.00
|
| Rate for Payer: BCN Commercial |
$67.22
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$81.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$86.70
|
| Rate for Payer: Healthscope Whirlpool |
$84.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.35
|
| Rate for Payer: Mclaren Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$21.29
|
| Rate for Payer: PHP Medicaid |
$10.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$60.78
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$29.99
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP DNSP |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$86.70 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: ASR ASR |
$84.10
|
| Rate for Payer: ASR Commercial |
$84.10
|
| Rate for Payer: BCBS Trust/PPO |
$70.65
|
| Rate for Payer: BCN Commercial |
$67.22
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$81.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$86.70
|
| Rate for Payer: Healthscope Whirlpool |
$84.10
|
| Rate for Payer: Mclaren Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.30
|
|
|
HC HIV ANTIBODY
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PACE Medicare |
$13.02
|
| Rate for Payer: PACE SWMI |
$13.71
|
| Rate for Payer: PHP Commercial |
$15.08
|
| Rate for Payer: PHP Medicaid |
$7.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.90
|
| Rate for Payer: Priority Health Medicare |
$13.71
|
| Rate for Payer: Priority Health Narrow Network |
$34.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.71
|
| Rate for Payer: UHC Exchange |
$21.25
|
| Rate for Payer: UHC Medicare Advantage |
$13.71
|
| Rate for Payer: UHCCP DNSP |
$13.71
|
| Rate for Payer: UHCCP Medicaid |
$7.35
|
| Rate for Payer: VA VA |
$13.71
|
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$13.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.14
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: ASR Commercial |
$47.49
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.71
|
| Rate for Payer: BCBS Trust/PPO |
$40.09
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: BCN Medicare Advantage |
$13.71
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.71
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.71
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Mclaren Medicare |
$13.71
|
|
|
HC HIV ANTIBODY
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: ASR Commercial |
$47.49
|
| Rate for Payer: BCBS Trust/PPO |
$39.90
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
|
|
HC HIV DNA BY PCR
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.16 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Aetna Commercial |
$80.52
|
| Rate for Payer: ASR ASR |
$86.79
|
| Rate for Payer: ASR Commercial |
$86.79
|
| Rate for Payer: BCBS Trust/PPO |
$72.91
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$84.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$89.47
|
| Rate for Payer: Healthscope Whirlpool |
$86.79
|
| Rate for Payer: Mclaren Commercial |
$80.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.73
|
|
|
HC HIV DNA BY PCR
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Aetna Commercial |
$80.52
|
| 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 |
$86.79
|
| Rate for Payer: ASR Commercial |
$86.79
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$73.27
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$84.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$89.47
|
| Rate for Payer: Healthscope Whirlpool |
$86.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$80.52
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| 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 |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.39
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$62.72
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
OP
|
$143.62
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$143.62 |
| Rate for Payer: Aetna Commercial |
$129.26
|
| Rate for Payer: Aetna Medicare |
$85.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: ASR ASR |
$139.31
|
| Rate for Payer: ASR Commercial |
$139.31
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCBS Trust/PPO |
$117.61
|
| Rate for Payer: BCN Commercial |
$111.35
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$143.62
|
| Rate for Payer: Healthscope Whirlpool |
$139.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.10
|
| Rate for Payer: Mclaren Commercial |
$129.26
|
| Rate for Payer: Mclaren Medicaid |
$45.61
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$47.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.08
|
| Rate for Payer: Nomi Health Commercial |
$117.77
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$93.61
|
| Rate for Payer: PHP Medicaid |
$45.61
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.84
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health Narrow Network |
$100.68
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.10
|
| Rate for Payer: UHC Exchange |
$131.91
|
| Rate for Payer: UHC Medicare Advantage |
$85.10
|
| Rate for Payer: UHCCP DNSP |
$85.10
|
| Rate for Payer: UHCCP Medicaid |
$45.61
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
IP
|
$143.62
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$143.62 |
| Rate for Payer: Aetna Commercial |
$129.26
|
| Rate for Payer: ASR ASR |
$139.31
|
| Rate for Payer: ASR Commercial |
$139.31
|
| Rate for Payer: BCBS Trust/PPO |
$117.04
|
| Rate for Payer: BCN Commercial |
$111.35
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.90
|
| Rate for Payer: Healthscope Commercial |
$143.62
|
| Rate for Payer: Healthscope Whirlpool |
$139.31
|
| Rate for Payer: Mclaren Commercial |
$129.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.08
|
| Rate for Payer: Nomi Health Commercial |
$117.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.39
|
|
|
HC HIV RNA BY PCR
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$208.08 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: ASR ASR |
$201.84
|
| Rate for Payer: ASR Commercial |
$201.84
|
| Rate for Payer: BCBS Trust/PPO |
$169.56
|
| Rate for Payer: BCN Commercial |
$161.32
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$195.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$208.08
|
| Rate for Payer: Healthscope Whirlpool |
$201.84
|
| Rate for Payer: Mclaren Commercial |
$187.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.11
|
|
|
HC HIV RNA BY PCR
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$208.08 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: Aetna Medicare |
$85.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: ASR ASR |
$201.84
|
| Rate for Payer: ASR Commercial |
$201.84
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCBS Trust/PPO |
$170.40
|
| Rate for Payer: BCN Commercial |
$161.32
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$195.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$208.08
|
| Rate for Payer: Healthscope Whirlpool |
$201.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.10
|
| Rate for Payer: Mclaren Commercial |
$187.27
|
| Rate for Payer: Mclaren Medicaid |
$45.61
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$47.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$93.61
|
| Rate for Payer: PHP Medicaid |
$45.61
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.32
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health Narrow Network |
$145.86
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.10
|
| Rate for Payer: UHC Exchange |
$131.91
|
| Rate for Payer: UHC Medicare Advantage |
$85.10
|
| Rate for Payer: UHCCP DNSP |
$85.10
|
| Rate for Payer: UHCCP Medicaid |
$45.61
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
OP
|
$139.21
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$139.21 |
| Rate for Payer: Aetna Commercial |
$125.29
|
| Rate for Payer: Aetna Medicare |
$85.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: ASR ASR |
$135.03
|
| Rate for Payer: ASR Commercial |
$135.03
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCBS Trust/PPO |
$114.00
|
| Rate for Payer: BCN Commercial |
$107.93
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cofinity Commercial |
$130.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$139.21
|
| Rate for Payer: Healthscope Whirlpool |
$135.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.10
|
| Rate for Payer: Mclaren Commercial |
$125.29
|
| Rate for Payer: Mclaren Medicaid |
$45.61
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$47.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.33
|
| Rate for Payer: Nomi Health Commercial |
$114.15
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$93.61
|
| Rate for Payer: PHP Medicaid |
$45.61
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.98
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health Narrow Network |
$97.59
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.10
|
| Rate for Payer: UHC Exchange |
$131.91
|
| Rate for Payer: UHC Medicare Advantage |
$85.10
|
| Rate for Payer: UHCCP DNSP |
$85.10
|
| Rate for Payer: UHCCP Medicaid |
$45.61
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
IP
|
$139.21
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.49 |
| Max. Negotiated Rate |
$139.21 |
| Rate for Payer: Aetna Commercial |
$125.29
|
| Rate for Payer: ASR ASR |
$135.03
|
| Rate for Payer: ASR Commercial |
$135.03
|
| Rate for Payer: BCBS Trust/PPO |
$113.44
|
| Rate for Payer: BCN Commercial |
$107.93
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cofinity Commercial |
$130.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.37
|
| Rate for Payer: Healthscope Commercial |
$139.21
|
| Rate for Payer: Healthscope Whirlpool |
$135.03
|
| Rate for Payer: Mclaren Commercial |
$125.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.33
|
| Rate for Payer: Nomi Health Commercial |
$114.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.50
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.96 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: ASR Commercial |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$83.95
|
| Rate for Payer: BCN Commercial |
$79.87
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$103.02
|
| Rate for Payer: Healthscope Whirlpool |
$99.93
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: Aetna Medicare |
$19.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: ASR Commercial |
$99.93
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$84.36
|
| Rate for Payer: BCN Commercial |
$79.87
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$103.02
|
| Rate for Payer: Healthscope Whirlpool |
$99.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.35
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$21.29
|
| Rate for Payer: PHP Medicaid |
$10.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.27
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$72.22
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$29.99
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP DNSP |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$69.61 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Trust/PPO |
$87.28
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$19.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.35
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$21.29
|
| Rate for Payer: PHP Medicaid |
$10.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.84
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$75.08
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$29.99
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP DNSP |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: VA VA |
$19.35
|
|
