|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,571.86
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,695.03 |
| Max. Negotiated Rate |
$3,873.46 |
| Rate for Payer: Aetna Commercial |
$3,214.67
|
| Rate for Payer: Aetna Medicare |
$3,098.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,873.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,873.46
|
| Rate for Payer: ASR ASR |
$3,464.70
|
| Rate for Payer: BCBS Complete |
$1,779.93
|
| Rate for Payer: BCBS MAPPO |
$3,098.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,769.26
|
| Rate for Payer: BCN Commercial |
$2,769.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,098.77
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,357.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,098.77
|
| Rate for Payer: Healthscope Commercial |
$3,571.86
|
| Rate for Payer: Healthscope Whirlpool |
$3,464.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,098.77
|
| Rate for Payer: Mclaren Commercial |
$3,214.67
|
| Rate for Payer: Mclaren Medicaid |
$1,695.03
|
| Rate for Payer: Mclaren Medicare |
$3,098.77
|
| Rate for Payer: Meridian Medicaid |
$1,779.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,253.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,563.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PACE Medicare |
$2,943.83
|
| Rate for Payer: PACE SWMI |
$3,098.77
|
| Rate for Payer: PHP Commercial |
$3,408.65
|
| Rate for Payer: PHP Medicaid |
$1,695.03
|
| Rate for Payer: PHP Medicare Advantage |
$3,098.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,250.39
|
| Rate for Payer: Priority Health Medicare |
$3,098.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,536.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,098.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,143.24
|
| Rate for Payer: UHC Medicare Advantage |
$3,191.73
|
| Rate for Payer: VA VA |
$3,098.77
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$263.00 |
| Rate for Payer: Aetna Commercial |
$236.70
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$255.11
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$203.90
|
| Rate for Payer: BCN Commercial |
$203.90
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$247.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$263.00
|
| Rate for Payer: Healthscope Whirlpool |
$255.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$236.70
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.33
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$186.73
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.44
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$184.10 |
| Max. Negotiated Rate |
$263.00 |
| Rate for Payer: Aetna Commercial |
$236.70
|
| Rate for Payer: ASR ASR |
$255.11
|
| Rate for Payer: BCBS Trust/PPO |
$203.90
|
| Rate for Payer: BCN Commercial |
$203.90
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$247.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Healthscope Commercial |
$263.00
|
| Rate for Payer: Healthscope Whirlpool |
$255.11
|
| Rate for Payer: Mclaren Commercial |
$236.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.44
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$155.25
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$108.68 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: ASR ASR |
$150.59
|
| Rate for Payer: BCBS Trust/PPO |
$120.37
|
| Rate for Payer: BCN Commercial |
$120.37
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$145.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.20
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Healthscope Whirlpool |
$150.59
|
| Rate for Payer: Mclaren Commercial |
$139.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.62
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$155.25
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$44.34 |
| Max. Negotiated Rate |
$399.39 |
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: Aetna Medicare |
$319.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: ASR ASR |
$150.59
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$120.37
|
| Rate for Payer: BCN Commercial |
$120.37
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$145.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Healthscope Whirlpool |
$150.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$319.51
|
| Rate for Payer: Mclaren Commercial |
$139.72
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.96
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$351.46
|
| Rate for Payer: PHP Medicaid |
$174.77
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.62
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: VA VA |
$319.51
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.49 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$46.10
|
| Rate for Payer: ASR ASR |
$49.68
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS Trust/PPO |
$39.71
|
| Rate for Payer: BCN Commercial |
$39.71
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$51.22
|
| Rate for Payer: Healthscope Whirlpool |
$49.68
|
| Rate for Payer: Mclaren Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.07
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$51.22 |
| Rate for Payer: Aetna Commercial |
$46.10
|
| Rate for Payer: ASR ASR |
$49.68
|
| Rate for Payer: BCBS Trust/PPO |
$39.71
|
| Rate for Payer: BCN Commercial |
$39.71
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$51.22
|
| Rate for Payer: Healthscope Whirlpool |
$49.68
|
| Rate for Payer: Mclaren Commercial |
$46.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.07
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$113.30
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$79.31 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna Commercial |
$101.97
|
| Rate for Payer: ASR ASR |
$109.90
|
| Rate for Payer: BCBS Trust/PPO |
$87.84
|
| Rate for Payer: BCN Commercial |
$87.84
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$106.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.64
|
| Rate for Payer: Healthscope Commercial |
$113.30
|
| Rate for Payer: Healthscope Whirlpool |
$109.90
|
| Rate for Payer: Mclaren Commercial |
$101.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.70
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$113.30
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna Commercial |
$101.97
|
| Rate for Payer: Aetna Medicare |
$48.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: ASR ASR |
$109.90
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$87.84
|
| Rate for Payer: BCN Commercial |
$87.84
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$106.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$113.30
|
| Rate for Payer: Healthscope Whirlpool |
$109.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$48.17
|
| Rate for Payer: Mclaren Commercial |
$101.97
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.30
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$52.99
|
| Rate for Payer: PHP Medicaid |
$26.35
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.10
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$80.44
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.70
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: VA VA |
$48.17
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$109.89 |
| Max. Negotiated Rate |
$156.98 |
| Rate for Payer: Aetna Commercial |
$141.28
|
| Rate for Payer: ASR ASR |
$152.27
|
| Rate for Payer: BCBS Trust/PPO |
$121.71
|
| Rate for Payer: BCN Commercial |
$121.71
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$147.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.58
|
| Rate for Payer: Healthscope Commercial |
$156.98
|
| Rate for Payer: Healthscope Whirlpool |
$152.27
|
| Rate for Payer: Mclaren Commercial |
$141.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.14
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.29 |
| Max. Negotiated Rate |
$156.98 |
| Rate for Payer: Aetna Commercial |
$141.28
|
| Rate for Payer: Aetna Medicare |
$64.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.64
|
| Rate for Payer: ASR ASR |
$152.27
|
| Rate for Payer: BCBS Complete |
$37.05
|
| Rate for Payer: BCBS MAPPO |
$64.51
|
| Rate for Payer: BCBS Trust/PPO |
$121.71
|
| Rate for Payer: BCN Commercial |
$121.71
|
| Rate for Payer: BCN Medicare Advantage |
$64.51
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$147.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.51
|
| Rate for Payer: Healthscope Commercial |
$156.98
|
| Rate for Payer: Healthscope Whirlpool |
$152.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$64.51
|
| Rate for Payer: Mclaren Commercial |
$141.28
|
| Rate for Payer: Mclaren Medicaid |
$35.29
|
| Rate for Payer: Mclaren Medicare |
$64.51
|
| Rate for Payer: Meridian Medicaid |
$37.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: PACE Medicare |
$61.28
|
| Rate for Payer: PACE SWMI |
$64.51
|
| Rate for Payer: PHP Commercial |
$70.96
|
| Rate for Payer: PHP Medicaid |
$35.29
|
| Rate for Payer: PHP Medicare Advantage |
$64.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.85
|
| Rate for Payer: Priority Health Medicare |
$64.51
|
| Rate for Payer: Priority Health Narrow Network |
$111.46
|
| Rate for Payer: Railroad Medicare Medicare |
$64.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.14
|
| Rate for Payer: UHC Medicare Advantage |
$66.45
|
| Rate for Payer: VA VA |
$64.51
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: Aetna Medicare |
$6.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: ASR ASR |
$82.12
|
| Rate for Payer: BCBS Complete |
$3.75
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$65.64
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$79.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.53
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$3.57
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Medicaid |
$3.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$7.18
|
| Rate for Payer: PHP Medicaid |
$3.57
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.04
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health Narrow Network |
$60.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.73
|
| Rate for Payer: VA VA |
$6.53
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.26 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: ASR ASR |
$82.12
|
| Rate for Payer: BCBS Trust/PPO |
$65.64
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$79.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$66.76 |
| Max. Negotiated Rate |
$95.37 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: ASR ASR |
$92.51
|
| Rate for Payer: BCBS Trust/PPO |
$73.94
|
| Rate for Payer: BCN Commercial |
$73.94
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$89.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Healthscope Commercial |
$95.37
|
| Rate for Payer: Healthscope Whirlpool |
$92.51
|
| Rate for Payer: Mclaren Commercial |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.93
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$95.37 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: ASR ASR |
$92.51
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$73.94
|
| Rate for Payer: BCN Commercial |
$73.94
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$89.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$95.37
|
| Rate for Payer: Healthscope Whirlpool |
$92.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.91
|
| Rate for Payer: Mclaren Commercial |
$85.83
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicaid |
$13.63
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.79
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$67.71
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.93
|
| Rate for Payer: UHC Medicare Advantage |
$25.66
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$97.92
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$234.48 |
| Rate for Payer: Aetna Commercial |
$88.13
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$94.98
|
| Rate for Payer: BCBS Complete |
$10.55
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$75.92
|
| Rate for Payer: BCN Commercial |
$75.92
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$92.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$97.92
|
| Rate for Payer: Healthscope Whirlpool |
$94.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$88.13
|
| Rate for Payer: Mclaren Medicaid |
$10.05
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Medicaid |
$10.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.23
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$10.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.48
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$187.58
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.17
|
| Rate for Payer: UHC Medicare Advantage |
$18.92
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$97.92
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$68.54 |
| Max. Negotiated Rate |
$97.92 |
| Rate for Payer: Aetna Commercial |
$88.13
|
| Rate for Payer: ASR ASR |
$94.98
|
| Rate for Payer: BCBS Trust/PPO |
$75.92
|
| Rate for Payer: BCN Commercial |
$75.92
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$92.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$97.92
|
| Rate for Payer: Healthscope Whirlpool |
$94.98
|
| Rate for Payer: Mclaren Commercial |
$88.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.17
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$273.67
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$66.79 |
| Max. Negotiated Rate |
$273.67 |
| Rate for Payer: Aetna Commercial |
$246.30
|
| Rate for Payer: Aetna Medicare |
$122.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.62
|
| Rate for Payer: ASR ASR |
$265.46
|
| Rate for Payer: BCBS Complete |
$70.13
|
| Rate for Payer: BCBS MAPPO |
$122.10
|
| Rate for Payer: BCBS Trust/PPO |
$212.18
|
| Rate for Payer: BCN Commercial |
$212.18
|
| Rate for Payer: BCN Medicare Advantage |
$122.10
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cofinity Commercial |
$257.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.10
|
| Rate for Payer: Healthscope Commercial |
$273.67
|
| Rate for Payer: Healthscope Whirlpool |
$265.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$122.10
|
| Rate for Payer: Mclaren Commercial |
$246.30
|
| Rate for Payer: Mclaren Medicaid |
$66.79
|
| Rate for Payer: Mclaren Medicare |
$122.10
|
| Rate for Payer: Meridian Medicaid |
$70.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.62
|
| Rate for Payer: PACE Medicare |
$116.00
|
| Rate for Payer: PACE SWMI |
$122.10
|
| Rate for Payer: PHP Commercial |
$134.31
|
| Rate for Payer: PHP Medicaid |
$66.79
|
| Rate for Payer: PHP Medicare Advantage |
$122.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.18
|
| Rate for Payer: Priority Health Medicare |
$122.10
|
| Rate for Payer: Priority Health Narrow Network |
$183.34
|
| Rate for Payer: Railroad Medicare Medicare |
$122.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.83
|
| Rate for Payer: UHC Medicare Advantage |
$125.76
|
| Rate for Payer: VA VA |
$122.10
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$273.67
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$191.57 |
| Max. Negotiated Rate |
$273.67 |
| Rate for Payer: Aetna Commercial |
$246.30
|
| Rate for Payer: ASR ASR |
$265.46
|
| Rate for Payer: BCBS Trust/PPO |
$212.18
|
| Rate for Payer: BCN Commercial |
$212.18
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cofinity Commercial |
$257.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.94
|
| Rate for Payer: Healthscope Commercial |
$273.67
|
| Rate for Payer: Healthscope Whirlpool |
$265.46
|
| Rate for Payer: Mclaren Commercial |
$246.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.83
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.53 |
| Max. Negotiated Rate |
$37.90 |
| Rate for Payer: Aetna Commercial |
$34.11
|
| Rate for Payer: ASR ASR |
$36.76
|
| Rate for Payer: BCBS Trust/PPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$35.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$37.90
|
| Rate for Payer: Healthscope Whirlpool |
$36.76
|
| Rate for Payer: Mclaren Commercial |
$34.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.35
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$37.90 |
| Rate for Payer: Aetna Commercial |
$34.11
|
| Rate for Payer: Aetna Medicare |
$4.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.60
|
| Rate for Payer: ASR ASR |
$36.76
|
| Rate for Payer: BCBS Complete |
$2.57
|
| Rate for Payer: BCBS MAPPO |
$4.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$4.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$35.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$37.90
|
| Rate for Payer: Healthscope Whirlpool |
$36.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.48
|
| Rate for Payer: Mclaren Commercial |
$34.11
|
| Rate for Payer: Mclaren Medicaid |
$2.45
|
| Rate for Payer: Mclaren Medicare |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Medicare |
$4.26
|
| Rate for Payer: PACE SWMI |
$4.48
|
| Rate for Payer: PHP Commercial |
$4.93
|
| Rate for Payer: PHP Medicaid |
$2.45
|
| Rate for Payer: PHP Medicare Advantage |
$4.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health Narrow Network |
$26.91
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: VA VA |
$4.48
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$121.58
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$121.58 |
| Rate for Payer: Aetna Commercial |
$109.42
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: ASR ASR |
$117.93
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$94.26
|
| Rate for Payer: BCN Commercial |
$94.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cofinity Commercial |
$114.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$121.58
|
| Rate for Payer: Healthscope Whirlpool |
$117.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.91
|
| Rate for Payer: Mclaren Commercial |
$109.42
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.34
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicaid |
$13.63
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.64
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$86.32
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.99
|
| Rate for Payer: UHC Medicare Advantage |
$25.66
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$121.58
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$85.11 |
| Max. Negotiated Rate |
$121.58 |
| Rate for Payer: Aetna Commercial |
$109.42
|
| Rate for Payer: ASR ASR |
$117.93
|
| Rate for Payer: BCBS Trust/PPO |
$94.26
|
| Rate for Payer: BCN Commercial |
$94.26
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cofinity Commercial |
$114.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.26
|
| Rate for Payer: Healthscope Commercial |
$121.58
|
| Rate for Payer: Healthscope Whirlpool |
$117.93
|
| Rate for Payer: Mclaren Commercial |
$109.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.99
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$394.64
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$117.69 |
| Max. Negotiated Rate |
$394.64 |
| Rate for Payer: Aetna Commercial |
$355.18
|
| Rate for Payer: Aetna Medicare |
$215.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.95
|
| Rate for Payer: ASR ASR |
$382.80
|
| Rate for Payer: BCBS Complete |
$123.59
|
| Rate for Payer: BCBS MAPPO |
$215.16
|
| Rate for Payer: BCBS Trust/PPO |
$305.96
|
| Rate for Payer: BCN Commercial |
$305.96
|
| Rate for Payer: BCN Medicare Advantage |
$215.16
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cofinity Commercial |
$370.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.16
|
| Rate for Payer: Healthscope Commercial |
$394.64
|
| Rate for Payer: Healthscope Whirlpool |
$382.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.16
|
| Rate for Payer: Mclaren Commercial |
$355.18
|
| Rate for Payer: Mclaren Medicaid |
$117.69
|
| Rate for Payer: Mclaren Medicare |
$215.16
|
| Rate for Payer: Meridian Medicaid |
$123.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$225.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.44
|
| Rate for Payer: PACE Medicare |
$204.40
|
| Rate for Payer: PACE SWMI |
$215.16
|
| Rate for Payer: PHP Commercial |
$236.68
|
| Rate for Payer: PHP Medicaid |
$117.69
|
| Rate for Payer: PHP Medicare Advantage |
$215.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.12
|
| Rate for Payer: Priority Health Medicare |
$215.16
|
| Rate for Payer: Priority Health Narrow Network |
$280.19
|
| Rate for Payer: Railroad Medicare Medicare |
$215.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$347.28
|
| Rate for Payer: UHC Medicare Advantage |
$221.61
|
| Rate for Payer: VA VA |
$215.16
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$394.64
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$276.25 |
| Max. Negotiated Rate |
$394.64 |
| Rate for Payer: Aetna Commercial |
$355.18
|
| Rate for Payer: ASR ASR |
$382.80
|
| Rate for Payer: BCBS Trust/PPO |
$305.96
|
| Rate for Payer: BCN Commercial |
$305.96
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cofinity Commercial |
$370.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.71
|
| Rate for Payer: Healthscope Commercial |
$394.64
|
| Rate for Payer: Healthscope Whirlpool |
$382.80
|
| Rate for Payer: Mclaren Commercial |
$355.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$347.28
|
|
