|
HC IMMUNIZATION 18YEARS OR YOUNGER
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 90460
|
| Hospital Charge Code |
77100001
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC IMMUNIZATION 18YEARS OR YOUNGER
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 90460
|
| Hospital Charge Code |
77100001
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.81
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC IMMUNIZATION 1ST VACCINE
|
Facility
|
OP
|
$33.66
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
77100003
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.88 |
| Max. Negotiated Rate |
$107.59 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$32.65
|
| Rate for Payer: ASR Commercial |
$32.65
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$27.56
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$31.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$30.29
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.61
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.49
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$23.60
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC IMMUNIZATION 1ST VACCINE
|
Facility
|
IP
|
$33.66
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
77100003
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.88 |
| Max. Negotiated Rate |
$33.66 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: ASR ASR |
$32.65
|
| Rate for Payer: ASR Commercial |
$32.65
|
| Rate for Payer: BCBS Trust/PPO |
$27.43
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$31.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.65
|
| Rate for Payer: Mclaren Commercial |
$30.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.61
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.62
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE
|
Facility
|
IP
|
$34.12
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
77100004
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$22.18 |
| Max. Negotiated Rate |
$34.12 |
| Rate for Payer: Aetna Commercial |
$30.71
|
| Rate for Payer: ASR ASR |
$33.10
|
| Rate for Payer: ASR Commercial |
$33.10
|
| Rate for Payer: BCBS Trust/PPO |
$27.80
|
| Rate for Payer: BCN Commercial |
$26.45
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$32.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$34.12
|
| Rate for Payer: Healthscope Whirlpool |
$33.10
|
| Rate for Payer: Mclaren Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.03
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE
|
Facility
|
OP
|
$34.12
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
77100004
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$34.12 |
| Rate for Payer: Aetna Commercial |
$30.71
|
| Rate for Payer: Aetna Medicare |
$17.06
|
| Rate for Payer: ASR ASR |
$33.10
|
| Rate for Payer: ASR Commercial |
$33.10
|
| Rate for Payer: BCBS Complete |
$13.65
|
| Rate for Payer: BCBS Trust/PPO |
$27.94
|
| Rate for Payer: BCN Commercial |
$26.45
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$32.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$34.12
|
| Rate for Payer: Healthscope Whirlpool |
$33.10
|
| Rate for Payer: Mclaren Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.90
|
| Rate for Payer: Priority Health Narrow Network |
$23.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.03
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: ASR ASR |
$24.73
|
| Rate for Payer: ASR Commercial |
$24.73
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$20.88
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.73
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.34
|
| Rate for Payer: Priority Health Narrow Network |
$17.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.73
|
| Rate for Payer: ASR Commercial |
$24.73
|
| Rate for Payer: BCBS Trust/PPO |
$20.78
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.73
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
IP
|
$37.54
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$37.54 |
| Rate for Payer: Aetna Commercial |
$33.79
|
| Rate for Payer: ASR ASR |
$36.41
|
| Rate for Payer: ASR Commercial |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$30.59
|
| Rate for Payer: BCN Commercial |
$29.10
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cofinity Commercial |
$35.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.03
|
| Rate for Payer: Healthscope Commercial |
$37.54
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Mclaren Commercial |
$33.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.91
|
| Rate for Payer: Nomi Health Commercial |
$30.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.04
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
OP
|
$37.54
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$107.59 |
| Rate for Payer: Aetna Commercial |
$33.79
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$36.41
|
| Rate for Payer: ASR Commercial |
$36.41
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$30.74
|
| Rate for Payer: BCN Commercial |
$29.10
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cofinity Commercial |
$35.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$37.54
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$33.79
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.91
|
| Rate for Payer: Nomi Health Commercial |
$30.78
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.89
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$26.32
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
OP
|
$27.54
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: ASR ASR |
$26.71
|
| Rate for Payer: ASR Commercial |
$26.71
|
| Rate for Payer: BCBS Complete |
$11.02
|
| Rate for Payer: BCBS Trust/PPO |
$22.55
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Healthscope Whirlpool |
$26.71
|
| Rate for Payer: Mclaren Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.41
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.13
|
| Rate for Payer: Priority Health Narrow Network |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.24
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
IP
|
$27.54
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: ASR ASR |
$26.71
|
| Rate for Payer: ASR Commercial |
$26.71
|
| Rate for Payer: BCBS Trust/PPO |
$22.44
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Healthscope Whirlpool |
$26.71
|
| Rate for Payer: Mclaren Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.41
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.24
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$24.97 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: ASR Commercial |
$24.22
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$20.45
|
| Rate for Payer: BCN Commercial |
$19.36
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$24.97
|
| Rate for Payer: Healthscope Whirlpool |
$24.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.88
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$17.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$24.97 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: ASR Commercial |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.35
|
| Rate for Payer: BCN Commercial |
$19.36
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$24.97
|
| Rate for Payer: Healthscope Whirlpool |
$24.22
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
IP
|
$39.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$39.02 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Trust/PPO |
$31.80
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
OP
|
$39.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$39.02 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.19
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$27.35
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC IMMUNOASSAY MULTI STEP FIRST
|
Facility
|
IP
|
$39.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100657
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$39.02 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Trust/PPO |
$31.80
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
|
|
HC IMMUNOASSAY MULTI STEP FIRST
|
Facility
|
OP
|
$39.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100657
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$39.02 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.19
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$27.35
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC IMMUNODIFFUSION
|
Facility
|
IP
|
$125.46
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
30200191
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$81.55 |
| Max. Negotiated Rate |
$125.46 |
| Rate for Payer: Aetna Commercial |
$112.91
|
| Rate for Payer: ASR ASR |
$121.70
|
| Rate for Payer: ASR Commercial |
$121.70
|
| Rate for Payer: BCBS Trust/PPO |
$102.24
|
| Rate for Payer: BCN Commercial |
$97.27
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$117.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.37
|
| Rate for Payer: Healthscope Commercial |
$125.46
|
| Rate for Payer: Healthscope Whirlpool |
$121.70
|
| Rate for Payer: Mclaren Commercial |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.64
|
| Rate for Payer: Nomi Health Commercial |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.40
|
|
|
HC IMMUNODIFFUSION
|
Facility
|
OP
|
$125.46
|
|
|
Service Code
|
CPT 86329
|
| Hospital Charge Code |
30200191
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$125.46 |
| Rate for Payer: Aetna Commercial |
$112.91
|
| Rate for Payer: Aetna Medicare |
$14.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.56
|
| Rate for Payer: ASR ASR |
$121.70
|
| Rate for Payer: ASR Commercial |
$121.70
|
| Rate for Payer: BCBS Complete |
$7.91
|
| Rate for Payer: BCBS MAPPO |
$14.05
|
| Rate for Payer: BCBS Trust/PPO |
$102.74
|
| Rate for Payer: BCN Commercial |
$97.27
|
| Rate for Payer: BCN Medicare Advantage |
$14.05
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cash Price |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$117.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.05
|
| Rate for Payer: Healthscope Commercial |
$125.46
|
| Rate for Payer: Healthscope Whirlpool |
$121.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.05
|
| Rate for Payer: Mclaren Commercial |
$112.91
|
| Rate for Payer: Mclaren Medicaid |
$7.53
|
| Rate for Payer: Mclaren Medicare |
$14.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.75
|
| Rate for Payer: Meridian Medicaid |
$7.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.64
|
| Rate for Payer: Nomi Health Commercial |
$102.88
|
| Rate for Payer: PACE Medicare |
$13.35
|
| Rate for Payer: PACE SWMI |
$14.05
|
| Rate for Payer: PHP Commercial |
$15.46
|
| Rate for Payer: PHP Medicaid |
$7.53
|
| Rate for Payer: PHP Medicare Advantage |
$14.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.93
|
| Rate for Payer: Priority Health Medicare |
$14.05
|
| Rate for Payer: Priority Health Narrow Network |
$87.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.05
|
| Rate for Payer: UHC Exchange |
$21.78
|
| Rate for Payer: UHC Medicare Advantage |
$14.05
|
| Rate for Payer: UHCCP DNSP |
$14.05
|
| Rate for Payer: UHCCP Medicaid |
$7.53
|
| Rate for Payer: VA VA |
$14.05
|
|
|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
OP
|
$79.07
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$79.07 |
| Rate for Payer: Aetna Commercial |
$71.16
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$76.70
|
| Rate for Payer: ASR Commercial |
$76.70
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$64.75
|
| Rate for Payer: BCN Commercial |
$61.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$79.07
|
| Rate for Payer: Healthscope Whirlpool |
$76.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$71.16
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.28
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$55.43
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
IP
|
$79.07
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.40 |
| Max. Negotiated Rate |
$79.07 |
| Rate for Payer: Aetna Commercial |
$71.16
|
| Rate for Payer: ASR ASR |
$76.70
|
| Rate for Payer: ASR Commercial |
$76.70
|
| Rate for Payer: BCBS Trust/PPO |
$64.43
|
| Rate for Payer: BCN Commercial |
$61.30
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Healthscope Commercial |
$79.07
|
| Rate for Payer: Healthscope Whirlpool |
$76.70
|
| Rate for Payer: Mclaren Commercial |
$71.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.58
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.51 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial |
$82.40
|
| Rate for Payer: ASR ASR |
$88.81
|
| Rate for Payer: ASR Commercial |
$88.81
|
| Rate for Payer: BCBS Trust/PPO |
$74.61
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$86.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$91.56
|
| Rate for Payer: Healthscope Whirlpool |
$88.81
|
| Rate for Payer: Mclaren Commercial |
$82.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.57
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial |
$82.40
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$88.81
|
| Rate for Payer: ASR Commercial |
$88.81
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$74.98
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$86.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$91.56
|
| Rate for Payer: Healthscope Whirlpool |
$88.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$82.40
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.22
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$64.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC IMMUNOFIXATION
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial |
$82.40
|
| Rate for Payer: Aetna Medicare |
$22.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.93
|
| Rate for Payer: ASR ASR |
$88.81
|
| Rate for Payer: ASR Commercial |
$88.81
|
| Rate for Payer: BCBS Complete |
$12.57
|
| Rate for Payer: BCBS MAPPO |
$22.34
|
| Rate for Payer: BCBS Trust/PPO |
$74.98
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: BCN Medicare Advantage |
$22.34
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$86.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.34
|
| Rate for Payer: Healthscope Commercial |
$91.56
|
| Rate for Payer: Healthscope Whirlpool |
$88.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.34
|
| Rate for Payer: Mclaren Commercial |
$82.40
|
| Rate for Payer: Mclaren Medicaid |
$11.97
|
| Rate for Payer: Mclaren Medicare |
$22.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.46
|
| Rate for Payer: Meridian Medicaid |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: PACE Medicare |
$21.22
|
| Rate for Payer: PACE SWMI |
$22.34
|
| Rate for Payer: PHP Commercial |
$24.57
|
| Rate for Payer: PHP Medicaid |
$11.97
|
| Rate for Payer: PHP Medicare Advantage |
$22.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.22
|
| Rate for Payer: Priority Health Medicare |
$22.34
|
| Rate for Payer: Priority Health Narrow Network |
$64.18
|
| Rate for Payer: Railroad Medicare Medicare |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.34
|
| Rate for Payer: UHC Exchange |
$34.63
|
| Rate for Payer: UHC Medicare Advantage |
$22.34
|
| Rate for Payer: UHCCP DNSP |
$22.34
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: VA VA |
$22.34
|
|
