|
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 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 |
$338.19 |
| 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 |
$338.19
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health Narrow Network |
$270.55
|
| 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 |
$131.90
|
| 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 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 |
$338.19 |
| 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 |
$338.19
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health Narrow Network |
$270.55
|
| 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 |
$131.90
|
| 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 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 |
$338.19 |
| 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 |
$338.19
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health Narrow Network |
$270.55
|
| 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 |
$131.90
|
| 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 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 |
$21.28
|
| 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 |
$69.62 |
| 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 |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| 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 |
$91.04
|
| 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 |
$21.28
|
| 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 |
$69.62
|
| 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
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| 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 |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$55.38
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.52
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| 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 |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| 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 |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow Network |
$47.41
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| 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 WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.72 |
| 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 |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| 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 |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| 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 |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.35
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| 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 |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$21.28
|
| 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 |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| 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 HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$180.65 |
| Max. Negotiated Rate |
$277.92 |
| Rate for Payer: Aetna Commercial |
$250.13
|
| Rate for Payer: ASR ASR |
$269.58
|
| Rate for Payer: ASR Commercial |
$269.58
|
| Rate for Payer: BCBS Trust/PPO |
$226.48
|
| Rate for Payer: BCN Commercial |
$215.47
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$261.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Healthscope Commercial |
$277.92
|
| Rate for Payer: Healthscope Whirlpool |
$269.58
|
| Rate for Payer: Mclaren Commercial |
$250.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: Nomi Health Commercial |
$227.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.57
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.07 |
| Max. Negotiated Rate |
$277.92 |
| Rate for Payer: Aetna Commercial |
$250.13
|
| Rate for Payer: Aetna Medicare |
$169.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.38
|
| Rate for Payer: ASR ASR |
$269.58
|
| Rate for Payer: ASR Commercial |
$269.58
|
| Rate for Payer: BCBS Complete |
$95.62
|
| Rate for Payer: BCBS MAPPO |
$169.90
|
| Rate for Payer: BCBS Trust/PPO |
$227.59
|
| Rate for Payer: BCN Commercial |
$215.47
|
| Rate for Payer: BCN Medicare Advantage |
$169.90
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$261.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.90
|
| Rate for Payer: Healthscope Commercial |
$277.92
|
| Rate for Payer: Healthscope Whirlpool |
$269.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$169.90
|
| Rate for Payer: Mclaren Commercial |
$250.13
|
| Rate for Payer: Mclaren Medicaid |
$91.07
|
| Rate for Payer: Mclaren Medicare |
$169.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.40
|
| Rate for Payer: Meridian Medicaid |
$95.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: Nomi Health Commercial |
$227.89
|
| Rate for Payer: PACE Medicare |
$161.40
|
| Rate for Payer: PACE SWMI |
$169.90
|
| Rate for Payer: PHP Commercial |
$186.89
|
| Rate for Payer: PHP Medicaid |
$91.07
|
| Rate for Payer: PHP Medicare Advantage |
$169.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.57
|
| Rate for Payer: Priority Health Medicare |
$169.90
|
| Rate for Payer: Priority Health Narrow Network |
$136.46
|
| Rate for Payer: Railroad Medicare Medicare |
$169.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.90
|
| Rate for Payer: UHC Exchange |
$263.34
|
| Rate for Payer: UHC Medicare Advantage |
$169.90
|
| Rate for Payer: UHCCP DNSP |
$169.90
|
| Rate for Payer: UHCCP Medicaid |
$91.07
|
| Rate for Payer: VA VA |
$169.90
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: ASR Commercial |
$48.44
|
| Rate for Payer: BCBS Complete |
$14.53
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$40.90
|
| Rate for Payer: BCN Commercial |
$38.72
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| 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 |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Healthscope Whirlpool |
$48.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.81
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$28.39
|
| Rate for Payer: PHP Medicaid |
$13.83
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.21
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$82.57
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.81
|
| Rate for Payer: UHC Exchange |
$40.01
|
| Rate for Payer: UHC Medicare Advantage |
$25.81
|
| Rate for Payer: UHCCP DNSP |
$25.81
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: VA VA |
$25.81
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.46 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: ASR Commercial |
$48.44
|
| Rate for Payer: BCBS Trust/PPO |
$40.70
|
| Rate for Payer: BCN Commercial |
$38.72
|
| 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: Healthscope Commercial |
$49.94
|
| Rate for Payer: Healthscope Whirlpool |
$48.44
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,756.75
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,791.89 |
| Max. Negotiated Rate |
$2,756.75 |
| Rate for Payer: Aetna Commercial |
$2,481.08
|
| Rate for Payer: ASR ASR |
$2,674.05
|
| Rate for Payer: ASR Commercial |
$2,674.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,246.48
|
| Rate for Payer: BCN Commercial |
$2,137.31
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cofinity Commercial |
$2,591.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,205.40
|
| Rate for Payer: Healthscope Commercial |
$2,756.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,674.05
|
| Rate for Payer: Mclaren Commercial |
$2,481.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.24
|
| Rate for Payer: Nomi Health Commercial |
$2,260.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,425.94
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,756.75
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$408.31 |
| Max. Negotiated Rate |
$2,756.75 |
| Rate for Payer: Aetna Commercial |
$2,481.08
|
| Rate for Payer: Aetna Medicare |
$761.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$952.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$952.21
|
| Rate for Payer: ASR ASR |
$2,674.05
|
| Rate for Payer: ASR Commercial |
$2,674.05
|
| Rate for Payer: BCBS Complete |
$428.72
|
| Rate for Payer: BCBS MAPPO |
$761.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,257.50
|
| Rate for Payer: BCN Commercial |
$2,137.31
|
| Rate for Payer: BCN Medicare Advantage |
$761.77
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cofinity Commercial |
$2,591.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,205.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.77
|
| Rate for Payer: Healthscope Commercial |
$2,756.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,674.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$761.77
|
| Rate for Payer: Mclaren Commercial |
$2,481.08
|
| Rate for Payer: Mclaren Medicaid |
$408.31
|
| Rate for Payer: Mclaren Medicare |
$761.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.86
|
| Rate for Payer: Meridian Medicaid |
$428.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$876.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.24
|
| Rate for Payer: Nomi Health Commercial |
$2,260.54
|
| Rate for Payer: PACE Medicare |
$723.68
|
| Rate for Payer: PACE SWMI |
$761.77
|
| Rate for Payer: PHP Commercial |
$837.95
|
| Rate for Payer: PHP Medicaid |
$408.31
|
| Rate for Payer: PHP Medicare Advantage |
$761.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,415.46
|
| Rate for Payer: Priority Health Medicare |
$761.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,932.48
|
| Rate for Payer: Railroad Medicare Medicare |
$761.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,425.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$761.77
|
| Rate for Payer: UHC Exchange |
$1,180.74
|
| Rate for Payer: UHC Medicare Advantage |
$761.77
|
| Rate for Payer: UHCCP DNSP |
$761.77
|
| Rate for Payer: UHCCP Medicaid |
$408.31
|
| Rate for Payer: VA VA |
$761.77
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$665.72
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$432.72 |
| Max. Negotiated Rate |
$665.72 |
| Rate for Payer: Aetna Commercial |
$599.15
|
| Rate for Payer: ASR ASR |
$645.75
|
| Rate for Payer: ASR Commercial |
$645.75
|
| Rate for Payer: BCBS Trust/PPO |
$542.50
|
| Rate for Payer: BCN Commercial |
$516.13
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cofinity Commercial |
$625.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.58
|
| Rate for Payer: Healthscope Commercial |
$665.72
|
| Rate for Payer: Healthscope Whirlpool |
$645.75
|
| Rate for Payer: Mclaren Commercial |
$599.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.86
|
| Rate for Payer: Nomi Health Commercial |
$545.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.83
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$665.72
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$665.72 |
| Rate for Payer: Aetna Commercial |
$599.15
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$645.75
|
| Rate for Payer: ASR Commercial |
$645.75
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$545.16
|
| Rate for Payer: BCN Commercial |
$516.13
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cofinity Commercial |
$625.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$665.72
|
| Rate for Payer: Healthscope Whirlpool |
$645.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$599.15
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.86
|
| Rate for Payer: Nomi Health Commercial |
$545.89
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.99
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$134.39
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,053.67
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$684.89 |
| Max. Negotiated Rate |
$1,053.67 |
| Rate for Payer: Aetna Commercial |
$948.30
|
| Rate for Payer: ASR ASR |
$1,022.06
|
| Rate for Payer: ASR Commercial |
$1,022.06
|
| Rate for Payer: BCBS Trust/PPO |
$858.64
|
| Rate for Payer: BCN Commercial |
$816.91
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cofinity Commercial |
$990.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.94
|
| Rate for Payer: Healthscope Commercial |
$1,053.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,022.06
|
| Rate for Payer: Mclaren Commercial |
$948.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.62
|
| Rate for Payer: Nomi Health Commercial |
$864.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$927.23
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,053.67
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,053.67 |
| Rate for Payer: Aetna Commercial |
$948.30
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$1,022.06
|
| Rate for Payer: ASR Commercial |
$1,022.06
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$862.85
|
| Rate for Payer: BCN Commercial |
$816.91
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cofinity Commercial |
$990.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$1,053.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,022.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$948.30
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.62
|
| Rate for Payer: Nomi Health Commercial |
$864.01
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.99
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$134.39
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$927.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
IP
|
$212.17
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$137.91 |
| Max. Negotiated Rate |
$212.17 |
| Rate for Payer: Aetna Commercial |
$190.95
|
| Rate for Payer: ASR ASR |
$205.80
|
| Rate for Payer: ASR Commercial |
$205.80
|
| Rate for Payer: BCBS Trust/PPO |
$172.90
|
| Rate for Payer: BCN Commercial |
$164.50
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$199.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Healthscope Commercial |
$212.17
|
| Rate for Payer: Healthscope Whirlpool |
$205.80
|
| Rate for Payer: Mclaren Commercial |
$190.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$173.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.71
|
|
