|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
IP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.71 |
| Max. Negotiated Rate |
$29.58 |
| Rate for Payer: Aetna Commercial |
$26.62
|
| Rate for Payer: ASR ASR |
$28.69
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Commercial |
$22.93
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Healthscope Commercial |
$29.58
|
| Rate for Payer: Healthscope Whirlpool |
$28.69
|
| Rate for Payer: Mclaren Commercial |
$26.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.03
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
OP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$197.03 |
| Rate for Payer: Aetna Commercial |
$26.62
|
| 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 |
$28.69
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Commercial |
$22.93
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$29.58
|
| Rate for Payer: Healthscope Whirlpool |
$28.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$26.62
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| 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 |
$6.31
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.03
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$157.62
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.03
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$138.53 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$13.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.30
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: BCBS Complete |
$7.95
|
| Rate for Payer: BCBS MAPPO |
$13.84
|
| Rate for Payer: BCBS Trust/PPO |
$48.24
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.84
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.84
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.84
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$7.57
|
| Rate for Payer: Mclaren Medicare |
$13.84
|
| Rate for Payer: Meridian Medicaid |
$7.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Medicare |
$13.15
|
| Rate for Payer: PACE SWMI |
$13.84
|
| Rate for Payer: PHP Commercial |
$15.22
|
| Rate for Payer: PHP Medicaid |
$7.57
|
| Rate for Payer: PHP Medicare Advantage |
$13.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.53
|
| Rate for Payer: Priority Health Medicare |
$13.84
|
| Rate for Payer: Priority Health Narrow Network |
$110.82
|
| Rate for Payer: Railroad Medicare Medicare |
$13.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Medicare Advantage |
$14.26
|
| Rate for Payer: VA VA |
$13.84
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$48.24
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: ASR ASR |
$53.35
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Healthscope Commercial |
$55.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.35
|
| Rate for Payer: Mclaren Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.40
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$224.73 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Medicare |
$12.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.01
|
| Rate for Payer: ASR ASR |
$53.35
|
| Rate for Payer: BCBS Complete |
$6.90
|
| Rate for Payer: BCBS MAPPO |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.01
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.01
|
| Rate for Payer: Healthscope Commercial |
$55.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.01
|
| Rate for Payer: Mclaren Commercial |
$49.50
|
| Rate for Payer: Mclaren Medicaid |
$6.57
|
| Rate for Payer: Mclaren Medicare |
$12.01
|
| Rate for Payer: Meridian Medicaid |
$6.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: PACE Medicare |
$11.41
|
| Rate for Payer: PACE SWMI |
$12.01
|
| Rate for Payer: PHP Commercial |
$13.21
|
| Rate for Payer: PHP Medicaid |
$6.57
|
| Rate for Payer: PHP Medicare Advantage |
$12.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.73
|
| Rate for Payer: Priority Health Medicare |
$12.01
|
| Rate for Payer: Priority Health Narrow Network |
$179.78
|
| Rate for Payer: Railroad Medicare Medicare |
$12.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.40
|
| Rate for Payer: UHC Medicare Advantage |
$12.37
|
| Rate for Payer: VA VA |
$12.01
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$61.57 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.42
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$6.17
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.74
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$5.87
|
| Rate for Payer: Mclaren Medicare |
$10.74
|
| Rate for Payer: Meridian Medicaid |
$6.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$10.20
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$11.81
|
| Rate for Payer: PHP Medicaid |
$5.87
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.57
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health Narrow Network |
$49.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$11.06
|
| Rate for Payer: VA VA |
$10.74
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
OP
|
$103.60
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$128.27 |
| Rate for Payer: Aetna Commercial |
$93.24
|
| Rate for Payer: Aetna Medicare |
$17.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.29
|
| Rate for Payer: ASR ASR |
$100.49
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$17.83
|
| Rate for Payer: BCBS Trust/PPO |
$80.32
|
| Rate for Payer: BCN Commercial |
$80.32
|
| Rate for Payer: BCN Medicare Advantage |
$17.83
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cofinity Commercial |
$97.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.83
|
| Rate for Payer: Healthscope Commercial |
$103.60
|
| Rate for Payer: Healthscope Whirlpool |
$100.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.83
|
| Rate for Payer: Mclaren Commercial |
$93.24
|
| Rate for Payer: Mclaren Medicaid |
$9.75
|
| Rate for Payer: Mclaren Medicare |
$17.83
|
| Rate for Payer: Meridian Medicaid |
$10.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.06
|
| Rate for Payer: PACE Medicare |
$16.94
|
| Rate for Payer: PACE SWMI |
$17.83
|
| Rate for Payer: PHP Commercial |
$19.61
|
| Rate for Payer: PHP Medicaid |
$9.75
|
| Rate for Payer: PHP Medicare Advantage |
$17.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.27
|
| Rate for Payer: Priority Health Medicare |
$17.83
|
| Rate for Payer: Priority Health Narrow Network |
$102.62
|
| Rate for Payer: Railroad Medicare Medicare |
$17.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.17
|
| Rate for Payer: UHC Medicare Advantage |
$18.36
|
| Rate for Payer: VA VA |
$17.83
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
IP
|
$103.60
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.52 |
| Max. Negotiated Rate |
$103.60 |
| Rate for Payer: Aetna Commercial |
$93.24
|
| Rate for Payer: ASR ASR |
$100.49
|
| Rate for Payer: BCBS Trust/PPO |
$80.32
|
| Rate for Payer: BCN Commercial |
$80.32
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cofinity Commercial |
$97.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.88
|
| Rate for Payer: Healthscope Commercial |
$103.60
|
| Rate for Payer: Healthscope Whirlpool |
$100.49
|
| Rate for Payer: Mclaren Commercial |
$93.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.17
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: Aetna Medicare |
$15.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: ASR ASR |
$59.17
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$47.29
|
| Rate for Payer: BCN Commercial |
$47.29
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$61.00
|
| Rate for Payer: Healthscope Whirlpool |
$59.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.32
|
| Rate for Payer: Mclaren Commercial |
$54.90
|
| Rate for Payer: Mclaren Medicaid |
$8.38
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Medicaid |
$8.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$16.85
|
| Rate for Payer: PHP Medicaid |
$8.38
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.75
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health Narrow Network |
$86.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.68
|
| Rate for Payer: UHC Medicare Advantage |
$15.78
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$61.00 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: ASR ASR |
$59.17
|
| Rate for Payer: BCBS Trust/PPO |
$47.29
|
| Rate for Payer: BCN Commercial |
$47.29
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Healthscope Commercial |
$61.00
|
| Rate for Payer: Healthscope Whirlpool |
$59.17
|
| Rate for Payer: Mclaren Commercial |
$54.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.68
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.50 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: ASR ASR |
$82.45
|
| Rate for Payer: BCBS Trust/PPO |
$65.90
|
| Rate for Payer: BCN Commercial |
$65.90
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$79.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Healthscope Whirlpool |
$82.45
|
| Rate for Payer: Mclaren Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.80
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$15.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: ASR ASR |
$82.45
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$65.90
|
| Rate for Payer: BCN Commercial |
$65.90
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$79.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Healthscope Whirlpool |
$82.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.32
|
| Rate for Payer: Mclaren Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$8.38
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Medicaid |
$8.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$16.85
|
| Rate for Payer: PHP Medicaid |
$8.38
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.75
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health Narrow Network |
$86.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.80
|
| Rate for Payer: UHC Medicare Advantage |
$15.78
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna Commercial |
$43.20
|
| Rate for Payer: Aetna Medicare |
$4.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: ASR ASR |
$46.56
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$37.21
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$48.00
|
| Rate for Payer: Healthscope Whirlpool |
$46.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.29
|
| Rate for Payer: Mclaren Commercial |
$43.20
|
| Rate for Payer: Mclaren Medicaid |
$2.35
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Medicaid |
$2.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$4.72
|
| Rate for Payer: PHP Medicaid |
$2.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.12
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow Network |
$19.30
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.24
|
| Rate for Payer: UHC Medicare Advantage |
$4.42
|
| Rate for Payer: VA VA |
$4.29
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna Commercial |
$43.20
|
| Rate for Payer: ASR ASR |
$46.56
|
| Rate for Payer: BCBS Trust/PPO |
$37.21
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Healthscope Commercial |
$48.00
|
| Rate for Payer: Healthscope Whirlpool |
$46.56
|
| Rate for Payer: Mclaren Commercial |
$43.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.24
|
|
|
HC PROTIME WITH INR
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$28.56 |
| Rate for Payer: Aetna Commercial |
$25.70
|
| Rate for Payer: Aetna Medicare |
$4.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: ASR ASR |
$27.70
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$22.14
|
| Rate for Payer: BCN Commercial |
$22.14
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$28.56
|
| Rate for Payer: Healthscope Whirlpool |
$27.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.29
|
| Rate for Payer: Mclaren Commercial |
$25.70
|
| Rate for Payer: Mclaren Medicaid |
$2.35
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Medicaid |
$2.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$4.72
|
| Rate for Payer: PHP Medicaid |
$2.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.12
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow Network |
$19.30
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.13
|
| Rate for Payer: UHC Medicare Advantage |
$4.42
|
| Rate for Payer: VA VA |
$4.29
|
|
|
HC PROTIME WITH INR
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.99 |
| Max. Negotiated Rate |
$28.56 |
| Rate for Payer: Aetna Commercial |
$25.70
|
| Rate for Payer: ASR ASR |
$27.70
|
| Rate for Payer: BCBS Trust/PPO |
$22.14
|
| Rate for Payer: BCN Commercial |
$22.14
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$28.56
|
| Rate for Payer: Healthscope Whirlpool |
$27.70
|
| Rate for Payer: Mclaren Commercial |
$25.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.13
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: ASR ASR |
$80.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.35
|
| Rate for Payer: BCN Commercial |
$64.35
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Healthscope Commercial |
$83.00
|
| Rate for Payer: Healthscope Whirlpool |
$80.51
|
| Rate for Payer: Mclaren Commercial |
$74.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.04
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: ASR ASR |
$80.51
|
| Rate for Payer: BCBS Complete |
$1.25
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$64.35
|
| Rate for Payer: BCN Commercial |
$64.35
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$83.00
|
| Rate for Payer: Healthscope Whirlpool |
$80.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.17
|
| Rate for Payer: Mclaren Commercial |
$74.70
|
| Rate for Payer: Mclaren Medicaid |
$1.19
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Medicaid |
$1.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$2.39
|
| Rate for Payer: PHP Medicaid |
$1.19
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.53
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$58.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.04
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| 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 PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.18 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: ASR ASR |
$82.12
|
| Rate for Payer: BCBS Complete |
$13.84
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$65.64
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| 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 |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$13.18
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$13.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$26.50
|
| Rate for Payer: PHP Medicaid |
$13.18
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.18
|
| 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 |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$60.11
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
| Rate for Payer: UHC Medicare Advantage |
$24.81
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
OP
|
$68.31
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$92.87 |
| Rate for Payer: Aetna Commercial |
$61.48
|
| Rate for Payer: Aetna Medicare |
$19.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.14
|
| Rate for Payer: ASR ASR |
$66.26
|
| Rate for Payer: BCBS Complete |
$11.09
|
| Rate for Payer: BCBS MAPPO |
$19.31
|
| Rate for Payer: BCBS Trust/PPO |
$52.96
|
| Rate for Payer: BCN Commercial |
$52.96
|
| Rate for Payer: BCN Medicare Advantage |
$19.31
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$64.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.31
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Healthscope Whirlpool |
$66.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.31
|
| Rate for Payer: Mclaren Commercial |
$61.48
|
| Rate for Payer: Mclaren Medicaid |
$10.56
|
| Rate for Payer: Mclaren Medicare |
$19.31
|
| Rate for Payer: Meridian Medicaid |
$11.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.06
|
| Rate for Payer: PACE Medicare |
$18.34
|
| Rate for Payer: PACE SWMI |
$19.31
|
| Rate for Payer: PHP Commercial |
$21.24
|
| Rate for Payer: PHP Medicaid |
$10.56
|
| Rate for Payer: PHP Medicare Advantage |
$19.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.87
|
| Rate for Payer: Priority Health Medicare |
$19.31
|
| Rate for Payer: Priority Health Narrow Network |
$74.30
|
| Rate for Payer: Railroad Medicare Medicare |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.11
|
| Rate for Payer: UHC Medicare Advantage |
$19.89
|
| Rate for Payer: VA VA |
$19.31
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
IP
|
$68.31
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.82 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$61.48
|
| Rate for Payer: ASR ASR |
$66.26
|
| Rate for Payer: BCBS Trust/PPO |
$52.96
|
| Rate for Payer: BCN Commercial |
$52.96
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$64.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.65
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Healthscope Whirlpool |
$66.26
|
| Rate for Payer: Mclaren Commercial |
$61.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.11
|
|
|
HC PSA FREE
|
Facility
|
OP
|
$68.31
|
|
|
Service Code
|
CPT 84154
|
| Hospital Charge Code |
30100405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$61.48
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.99
|
| Rate for Payer: ASR ASR |
$66.26
|
| Rate for Payer: BCBS Complete |
$10.56
|
| Rate for Payer: BCBS MAPPO |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$52.96
|
| Rate for Payer: BCN Commercial |
$52.96
|
| Rate for Payer: BCN Medicare Advantage |
$18.39
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$64.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.39
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Healthscope Whirlpool |
$66.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.39
|
| Rate for Payer: Mclaren Commercial |
$61.48
|
| Rate for Payer: Mclaren Medicaid |
$10.06
|
| Rate for Payer: Mclaren Medicare |
$18.39
|
| Rate for Payer: Meridian Medicaid |
$10.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.06
|
| Rate for Payer: PACE Medicare |
$17.47
|
| Rate for Payer: PACE SWMI |
$18.39
|
| Rate for Payer: PHP Commercial |
$20.23
|
| Rate for Payer: PHP Medicaid |
$10.06
|
| Rate for Payer: PHP Medicare Advantage |
$18.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow Network |
$42.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.11
|
| Rate for Payer: UHC Medicare Advantage |
$18.94
|
| Rate for Payer: VA VA |
$18.39
|
|
