|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
OP
|
$93.64
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: Aetna Medicare |
$34.65
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: BCBS Complete |
$37.46
|
| Rate for Payer: BCBS Trust/PPO |
$77.21
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$90.83
|
| Rate for Payer: Healthscope Whirlpool |
$93.64
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82.05
|
| Rate for Payer: Priority Health Narrow Network |
$65.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
IP
|
$93.64
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.23 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: BCBS Trust/PPO |
$76.90
|
| Rate for Payer: BCN Commercial |
$76.90
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$90.83
|
| Rate for Payer: Healthscope Whirlpool |
$93.64
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
|
|
HC LINE VACUUM
|
Facility
|
OP
|
$14.05
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$12.64
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: ASR ASR |
$13.63
|
| Rate for Payer: BCBS Complete |
$5.62
|
| Rate for Payer: BCBS Trust/PPO |
$11.58
|
| Rate for Payer: BCN Commercial |
$11.58
|
| Rate for Payer: Cash Price |
$11.24
|
| Rate for Payer: Cofinity Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.24
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Healthscope Whirlpool |
$14.05
|
| Rate for Payer: Mclaren Commercial |
$12.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.94
|
| Rate for Payer: Nomi Health Commercial |
$11.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.31
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.36
|
|
|
HC LINE VACUUM
|
Facility
|
IP
|
$14.05
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$12.64
|
| Rate for Payer: ASR ASR |
$13.63
|
| Rate for Payer: BCBS Trust/PPO |
$11.54
|
| Rate for Payer: BCN Commercial |
$11.54
|
| Rate for Payer: Cash Price |
$11.24
|
| Rate for Payer: Cofinity Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.24
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Healthscope Whirlpool |
$14.05
|
| Rate for Payer: Mclaren Commercial |
$12.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.94
|
| Rate for Payer: Nomi Health Commercial |
$11.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.36
|
|
|
HC LIPASE
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: Aetna Medicare |
$6.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$26.24
|
| Rate for Payer: BCN Commercial |
$26.24
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$30.88
|
| Rate for Payer: Healthscope Whirlpool |
$31.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.89
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Meridian Medicaid |
$3.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Commercial |
$7.58
|
| Rate for Payer: PHP Medicaid |
$3.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.02
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.89
|
| Rate for Payer: UHC Exchange |
$10.68
|
| Rate for Payer: UHC Medicaid |
$3.60
|
| Rate for Payer: UHCCP DNSP |
$6.89
|
| Rate for Payer: UHCCP Medicaid |
$3.60
|
| Rate for Payer: VA VA |
$6.89
|
|
|
HC LIPASE
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.87 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: BCBS Trust/PPO |
$26.14
|
| Rate for Payer: BCN Commercial |
$26.14
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$30.88
|
| Rate for Payer: Healthscope Whirlpool |
$31.83
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
|
|
HC LIPASE BF
|
Facility
|
IP
|
$58.45
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.84 |
| Max. Negotiated Rate |
$58.45 |
| Rate for Payer: Aetna Commercial |
$52.60
|
| Rate for Payer: ASR ASR |
$56.70
|
| Rate for Payer: BCBS Trust/PPO |
$48.00
|
| Rate for Payer: BCN Commercial |
$48.00
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cofinity Commercial |
$54.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.76
|
| Rate for Payer: Healthscope Commercial |
$56.70
|
| Rate for Payer: Healthscope Whirlpool |
$58.45
|
| Rate for Payer: Mclaren Commercial |
$52.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.68
|
| Rate for Payer: Nomi Health Commercial |
$47.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.44
|
|
|
HC LIPASE BF
|
Facility
|
OP
|
$58.45
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$52.60
|
| Rate for Payer: Aetna Medicare |
$6.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: ASR ASR |
$56.70
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$48.19
|
| Rate for Payer: BCN Commercial |
$48.19
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cofinity Commercial |
$54.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$56.70
|
| Rate for Payer: Healthscope Whirlpool |
$58.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.89
|
| Rate for Payer: Mclaren Commercial |
$52.60
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Meridian Medicaid |
$3.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.68
|
| Rate for Payer: Nomi Health Commercial |
$47.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.84
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Commercial |
$7.58
|
| Rate for Payer: PHP Medicaid |
$3.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.02
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.89
|
| Rate for Payer: UHC Exchange |
$10.68
|
| Rate for Payer: UHC Medicaid |
$3.60
|
| Rate for Payer: UHCCP DNSP |
$6.89
|
| Rate for Payer: UHCCP Medicaid |
$3.60
|
| Rate for Payer: VA VA |
$6.89
|
|
|
HC LIPID PANEL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$116.21 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$13.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.74
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$7.35
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.39
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Mclaren Medicare |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$7.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$12.72
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$14.73
|
| Rate for Payer: PHP Medicaid |
$7.18
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$116.21
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow Network |
$92.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.39
|
| Rate for Payer: UHC Exchange |
$20.75
|
| Rate for Payer: UHC Medicaid |
$7.00
|
| Rate for Payer: UHCCP DNSP |
$13.39
|
| Rate for Payer: UHCCP Medicaid |
$7.00
|
| Rate for Payer: VA VA |
$13.39
|
|
|
HC LIPID PANEL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.02 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.72
|
| Rate for Payer: BCN Commercial |
$42.72
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$50.46
|
| Rate for Payer: Healthscope Whirlpool |
$52.02
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$116.21 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$13.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.74
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: BCBS Complete |
$7.35
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$42.89
|
| Rate for Payer: BCN Commercial |
$42.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$50.46
|
| Rate for Payer: Healthscope Whirlpool |
$52.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.39
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Mclaren Medicare |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$7.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Medicare |
$12.72
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$14.73
|
| Rate for Payer: PHP Medicaid |
$7.18
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$116.21
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow Network |
$92.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.39
|
| Rate for Payer: UHC Exchange |
$20.75
|
| Rate for Payer: UHC Medicaid |
$7.00
|
| Rate for Payer: UHCCP DNSP |
$13.39
|
| Rate for Payer: UHCCP Medicaid |
$7.00
|
| Rate for Payer: VA VA |
$13.39
|
|
|
HC LIPOPROTEIN A
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC LIPOPROTEIN A
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$14.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.90
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$14.32
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.32
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.32
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.32
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$14.32
|
| Rate for Payer: Mclaren Medicare |
$14.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.04
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$13.60
|
| Rate for Payer: PACE SWMI |
$14.32
|
| Rate for Payer: PHP Commercial |
$15.75
|
| Rate for Payer: PHP Medicaid |
$7.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.19
|
| Rate for Payer: Priority Health Medicare |
$14.32
|
| Rate for Payer: Priority Health Narrow Network |
$29.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.32
|
| Rate for Payer: UHC Exchange |
$22.20
|
| Rate for Payer: UHC Medicaid |
$7.49
|
| Rate for Payer: UHCCP DNSP |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$7.49
|
| Rate for Payer: VA VA |
$14.32
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
IP
|
$372.35
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$279.26 |
| Max. Negotiated Rate |
$372.35 |
| Rate for Payer: Aetna Commercial |
$335.12
|
| Rate for Payer: ASR ASR |
$361.18
|
| Rate for Payer: BCBS Trust/PPO |
$305.77
|
| Rate for Payer: BCN Commercial |
$305.77
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cofinity Commercial |
$350.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.88
|
| Rate for Payer: Healthscope Commercial |
$361.18
|
| Rate for Payer: Healthscope Whirlpool |
$372.35
|
| Rate for Payer: Mclaren Commercial |
$335.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.50
|
| Rate for Payer: Nomi Health Commercial |
$305.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.67
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
OP
|
$372.35
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$372.35 |
| Rate for Payer: Aetna Commercial |
$335.12
|
| Rate for Payer: Aetna Medicare |
$83.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.81
|
| Rate for Payer: ASR ASR |
$361.18
|
| Rate for Payer: BCBS Complete |
$46.05
|
| Rate for Payer: BCBS MAPPO |
$83.85
|
| Rate for Payer: BCBS Trust/PPO |
$307.00
|
| Rate for Payer: BCN Commercial |
$307.00
|
| Rate for Payer: BCN Medicare Advantage |
$83.85
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cofinity Commercial |
$350.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.85
|
| Rate for Payer: Healthscope Commercial |
$361.18
|
| Rate for Payer: Healthscope Whirlpool |
$372.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$83.85
|
| Rate for Payer: Mclaren Commercial |
$335.12
|
| Rate for Payer: Mclaren Medicaid |
$83.85
|
| Rate for Payer: Mclaren Medicare |
$83.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.04
|
| Rate for Payer: Meridian Medicaid |
$46.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.50
|
| Rate for Payer: Nomi Health Commercial |
$305.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.26
|
| Rate for Payer: PACE Medicare |
$79.66
|
| Rate for Payer: PACE SWMI |
$83.85
|
| Rate for Payer: PHP Commercial |
$92.23
|
| Rate for Payer: PHP Medicaid |
$44.94
|
| Rate for Payer: PHP Medicare Advantage |
$83.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.75
|
| Rate for Payer: Priority Health Medicare |
$83.85
|
| Rate for Payer: Priority Health Narrow Network |
$104.60
|
| Rate for Payer: Railroad Medicare Medicare |
$83.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.85
|
| Rate for Payer: UHC Exchange |
$129.97
|
| Rate for Payer: UHC Medicaid |
$43.85
|
| Rate for Payer: UHCCP DNSP |
$83.85
|
| Rate for Payer: UHCCP Medicaid |
$43.85
|
| Rate for Payer: VA VA |
$83.85
|
|
|
HC LISTERIA MONOCYTOGENES
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC LISTERIA MONOCYTOGENES
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC LITHIUM LEVEL
|
Facility
|
OP
|
$56.04
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
30100034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$56.04 |
| Rate for Payer: Aetna Commercial |
$50.44
|
| Rate for Payer: Aetna Medicare |
$6.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.26
|
| Rate for Payer: ASR ASR |
$54.36
|
| Rate for Payer: BCBS Complete |
$3.63
|
| Rate for Payer: BCBS MAPPO |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$46.20
|
| Rate for Payer: BCN Commercial |
$46.20
|
| Rate for Payer: BCN Medicare Advantage |
$6.61
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Commercial |
$52.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.61
|
| Rate for Payer: Healthscope Commercial |
$54.36
|
| Rate for Payer: Healthscope Whirlpool |
$56.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.61
|
| Rate for Payer: Mclaren Commercial |
$50.44
|
| Rate for Payer: Mclaren Medicaid |
$6.61
|
| Rate for Payer: Mclaren Medicare |
$6.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.94
|
| Rate for Payer: Meridian Medicaid |
$3.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$45.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PACE Medicare |
$6.28
|
| Rate for Payer: PACE SWMI |
$6.61
|
| Rate for Payer: PHP Commercial |
$7.27
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.05
|
| Rate for Payer: Priority Health Medicare |
$6.61
|
| Rate for Payer: Priority Health Narrow Network |
$23.24
|
| Rate for Payer: Railroad Medicare Medicare |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.61
|
| Rate for Payer: UHC Exchange |
$10.25
|
| Rate for Payer: UHC Medicaid |
$3.46
|
| Rate for Payer: UHCCP DNSP |
$6.61
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: VA VA |
$6.61
|
|
|
HC LITHIUM LEVEL
|
Facility
|
IP
|
$56.04
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
30100034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.03 |
| Max. Negotiated Rate |
$56.04 |
| Rate for Payer: Aetna Commercial |
$50.44
|
| Rate for Payer: ASR ASR |
$54.36
|
| Rate for Payer: BCBS Trust/PPO |
$46.02
|
| Rate for Payer: BCN Commercial |
$46.02
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Commercial |
$52.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Healthscope Commercial |
$54.36
|
| Rate for Payer: Healthscope Whirlpool |
$56.04
|
| Rate for Payer: Mclaren Commercial |
$50.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$45.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.32
|
|
|
HC LITHOTRIPSY
|
Facility
|
IP
|
$2,909.09
|
|
| Hospital Charge Code |
36000072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,181.82 |
| Max. Negotiated Rate |
$2,909.09 |
| Rate for Payer: Aetna Commercial |
$2,618.18
|
| Rate for Payer: ASR ASR |
$2,821.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,388.94
|
| Rate for Payer: BCN Commercial |
$2,388.94
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Commercial |
$2,734.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,821.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,909.09
|
| Rate for Payer: Mclaren Commercial |
$2,618.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Nomi Health Commercial |
$2,385.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,560.00
|
|
|
HC LITHOTRIPSY
|
Facility
|
OP
|
$2,909.09
|
|
| Hospital Charge Code |
36000072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,076.36 |
| Max. Negotiated Rate |
$2,909.09 |
| Rate for Payer: Aetna Commercial |
$2,618.18
|
| Rate for Payer: Aetna Medicare |
$1,076.36
|
| Rate for Payer: ASR ASR |
$2,821.82
|
| Rate for Payer: BCBS Complete |
$1,163.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,398.54
|
| Rate for Payer: BCN Commercial |
$2,398.54
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Commercial |
$2,734.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,821.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,909.09
|
| Rate for Payer: Mclaren Commercial |
$2,618.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,327.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Nomi Health Commercial |
$2,385.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,548.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,039.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,560.00
|
|
|
HC LIVER BIOPSY
|
Facility
|
IP
|
$1,508.57
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,131.43 |
| Max. Negotiated Rate |
$1,508.57 |
| Rate for Payer: Aetna Commercial |
$1,357.71
|
| Rate for Payer: ASR ASR |
$1,463.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.84
|
| Rate for Payer: BCN Commercial |
$1,238.84
|
| Rate for Payer: Cash Price |
$1,206.86
|
| Rate for Payer: Cofinity Commercial |
$1,418.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,206.86
|
| Rate for Payer: Healthscope Commercial |
$1,463.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,508.57
|
| Rate for Payer: Mclaren Commercial |
$1,357.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.28
|
| Rate for Payer: Nomi Health Commercial |
$1,237.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,327.54
|
|
|
HC LIVER BIOPSY
|
Facility
|
OP
|
$1,508.57
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$558.17 |
| Max. Negotiated Rate |
$1,508.57 |
| Rate for Payer: Aetna Commercial |
$1,357.71
|
| Rate for Payer: Aetna Medicare |
$558.17
|
| Rate for Payer: ASR ASR |
$1,463.31
|
| Rate for Payer: BCBS Complete |
$603.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,243.82
|
| Rate for Payer: BCN Commercial |
$1,243.82
|
| Rate for Payer: Cash Price |
$1,206.86
|
| Rate for Payer: Cofinity Commercial |
$1,418.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,206.86
|
| Rate for Payer: Healthscope Commercial |
$1,463.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,508.57
|
| Rate for Payer: Mclaren Commercial |
$1,357.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.28
|
| Rate for Payer: Nomi Health Commercial |
$1,237.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,321.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,057.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,327.54
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
IP
|
$57.73
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.30 |
| Max. Negotiated Rate |
$57.73 |
| Rate for Payer: Aetna Commercial |
$51.96
|
| Rate for Payer: ASR ASR |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cofinity Commercial |
$54.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.18
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Healthscope Whirlpool |
$57.73
|
| Rate for Payer: Mclaren Commercial |
$51.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.07
|
| Rate for Payer: Nomi Health Commercial |
$47.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.80
|
|
