|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$180.51
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.38 |
| Max. Negotiated Rate |
$180.51 |
| Rate for Payer: Aetna Commercial |
$162.46
|
| Rate for Payer: ASR ASR |
$175.09
|
| Rate for Payer: BCBS Trust/PPO |
$148.23
|
| Rate for Payer: BCN Commercial |
$148.23
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Commercial |
$169.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Healthscope Commercial |
$175.09
|
| Rate for Payer: Healthscope Whirlpool |
$180.51
|
| Rate for Payer: Mclaren Commercial |
$162.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$148.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.85
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
IP
|
$63.58
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.69 |
| Max. Negotiated Rate |
$63.58 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: ASR ASR |
$61.67
|
| Rate for Payer: BCBS Trust/PPO |
$52.21
|
| Rate for Payer: BCN Commercial |
$52.21
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Commercial |
$59.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$61.67
|
| Rate for Payer: Healthscope Whirlpool |
$63.58
|
| Rate for Payer: Mclaren Commercial |
$57.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.04
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.95
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
OP
|
$63.58
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.09 |
| Max. Negotiated Rate |
$157.38 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$21.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.51
|
| Rate for Payer: ASR ASR |
$61.67
|
| Rate for Payer: BCBS Complete |
$11.65
|
| Rate for Payer: BCBS MAPPO |
$21.21
|
| Rate for Payer: BCBS Trust/PPO |
$52.42
|
| Rate for Payer: BCN Commercial |
$52.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.21
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Commercial |
$59.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.21
|
| Rate for Payer: Healthscope Commercial |
$61.67
|
| Rate for Payer: Healthscope Whirlpool |
$63.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.21
|
| Rate for Payer: Mclaren Commercial |
$57.22
|
| Rate for Payer: Mclaren Medicaid |
$21.21
|
| Rate for Payer: Mclaren Medicare |
$21.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.27
|
| Rate for Payer: Meridian Medicaid |
$11.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.04
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.69
|
| Rate for Payer: PACE Medicare |
$20.15
|
| Rate for Payer: PACE SWMI |
$21.21
|
| Rate for Payer: PHP Commercial |
$23.33
|
| Rate for Payer: PHP Medicaid |
$11.37
|
| Rate for Payer: PHP Medicare Advantage |
$21.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.38
|
| Rate for Payer: Priority Health Medicare |
$21.21
|
| Rate for Payer: Priority Health Narrow Network |
$125.91
|
| Rate for Payer: Railroad Medicare Medicare |
$21.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.21
|
| Rate for Payer: UHC Exchange |
$32.88
|
| Rate for Payer: UHC Medicaid |
$11.09
|
| Rate for Payer: UHCCP DNSP |
$21.21
|
| Rate for Payer: UHCCP Medicaid |
$11.09
|
| Rate for Payer: VA VA |
$21.21
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$334.79 |
| Max. Negotiated Rate |
$446.38 |
| Rate for Payer: Aetna Commercial |
$401.74
|
| Rate for Payer: ASR ASR |
$432.99
|
| Rate for Payer: BCBS Trust/PPO |
$366.57
|
| Rate for Payer: BCN Commercial |
$366.57
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$419.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$432.99
|
| Rate for Payer: Healthscope Whirlpool |
$446.38
|
| Rate for Payer: Mclaren Commercial |
$401.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.81
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$470.63 |
| Rate for Payer: Aetna Commercial |
$401.74
|
| Rate for Payer: Aetna Medicare |
$303.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: ASR ASR |
$432.99
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$368.04
|
| Rate for Payer: BCN Commercial |
$368.04
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$419.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$432.99
|
| Rate for Payer: Healthscope Whirlpool |
$446.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.63
|
| Rate for Payer: Mclaren Commercial |
$401.74
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$166.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$333.99
|
| Rate for Payer: PHP Medicaid |
$162.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$391.12
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health Narrow Network |
$312.91
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$470.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP DNSP |
$303.63
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: VA VA |
$303.63
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
OP
|
$85.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$345.01 |
| Rate for Payer: Aetna Commercial |
$76.63
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$82.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$70.20
|
| Rate for Payer: BCN Commercial |
$70.20
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cofinity Commercial |
$80.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$82.59
|
| Rate for Payer: Healthscope Whirlpool |
$85.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$76.63
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.37
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.85
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$345.01
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$276.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
IP
|
$85.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.85 |
| Max. Negotiated Rate |
$85.14 |
| Rate for Payer: Aetna Commercial |
$76.63
|
| Rate for Payer: ASR ASR |
$82.59
|
| Rate for Payer: BCBS Trust/PPO |
$69.92
|
| Rate for Payer: BCN Commercial |
$69.92
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cofinity Commercial |
$80.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.11
|
| Rate for Payer: Healthscope Commercial |
$82.59
|
| Rate for Payer: Healthscope Whirlpool |
$85.14
|
| Rate for Payer: Mclaren Commercial |
$76.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.37
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.92
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
IP
|
$82.77
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.08 |
| Max. Negotiated Rate |
$82.77 |
| Rate for Payer: Aetna Commercial |
$74.49
|
| Rate for Payer: ASR ASR |
$80.29
|
| Rate for Payer: BCBS Trust/PPO |
$67.97
|
| Rate for Payer: BCN Commercial |
$67.97
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Commercial |
$77.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Healthscope Commercial |
$80.29
|
| Rate for Payer: Healthscope Whirlpool |
$82.77
|
| Rate for Payer: Mclaren Commercial |
$74.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$67.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.84
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
OP
|
$82.77
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$74.49
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$80.29
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$68.24
|
| Rate for Payer: BCN Commercial |
$68.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Commercial |
$77.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$80.29
|
| Rate for Payer: Healthscope Whirlpool |
$82.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$74.49
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$67.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$195.07 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna Commercial |
$234.09
|
| Rate for Payer: ASR ASR |
$252.30
|
| Rate for Payer: BCBS Trust/PPO |
$213.59
|
| Rate for Payer: BCN Commercial |
$213.59
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$252.30
|
| Rate for Payer: Healthscope Whirlpool |
$260.10
|
| Rate for Payer: Mclaren Commercial |
$234.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.89
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna Commercial |
$234.09
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$252.30
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$214.45
|
| Rate for Payer: BCN Commercial |
$214.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$252.30
|
| Rate for Payer: Healthscope Whirlpool |
$260.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$234.09
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.69 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.36
|
| Rate for Payer: BCN Commercial |
$65.36
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$65.62
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$65.62
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.69 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.36
|
| Rate for Payer: BCN Commercial |
$65.36
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
OP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$65.91
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$71.03
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCN Commercial |
$60.38
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Commercial |
$68.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$73.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$65.91
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
IP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.92 |
| Max. Negotiated Rate |
$73.23 |
| Rate for Payer: Aetna Commercial |
$65.91
|
| Rate for Payer: ASR ASR |
$71.03
|
| Rate for Payer: BCBS Trust/PPO |
$60.14
|
| Rate for Payer: BCN Commercial |
$60.14
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Commercial |
$68.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$73.23
|
| Rate for Payer: Mclaren Commercial |
$65.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.44
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
OP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$65.91
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$71.03
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCN Commercial |
$60.38
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Commercial |
$68.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$73.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$65.91
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
IP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.92 |
| Max. Negotiated Rate |
$73.23 |
| Rate for Payer: Aetna Commercial |
$65.91
|
| Rate for Payer: ASR ASR |
$71.03
|
| Rate for Payer: BCBS Trust/PPO |
$60.14
|
| Rate for Payer: BCN Commercial |
$60.14
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Commercial |
$68.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$73.23
|
| Rate for Payer: Mclaren Commercial |
$65.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.44
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
OP
|
$73.23
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$345.01 |
| Rate for Payer: Aetna Commercial |
$65.91
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$71.03
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCN Commercial |
$60.38
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Commercial |
$68.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$73.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$65.91
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$345.01
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$276.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
IP
|
$73.23
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.92 |
| Max. Negotiated Rate |
$73.23 |
| Rate for Payer: Aetna Commercial |
$65.91
|
| Rate for Payer: ASR ASR |
$71.03
|
| Rate for Payer: BCBS Trust/PPO |
$60.14
|
| Rate for Payer: BCN Commercial |
$60.14
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Commercial |
$68.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$73.23
|
| Rate for Payer: Mclaren Commercial |
$65.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.44
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$46.70 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Trust/PPO |
$38.35
|
| Rate for Payer: BCN Commercial |
$38.35
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$46.70 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: Aetna Medicare |
$8.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.81
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS MAPPO |
$8.65
|
| Rate for Payer: BCBS Trust/PPO |
$38.50
|
| Rate for Payer: BCN Commercial |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.65
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.65
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.65
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$8.65
|
| Rate for Payer: Mclaren Medicare |
$8.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.08
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$8.22
|
| Rate for Payer: PACE SWMI |
$8.65
|
| Rate for Payer: PHP Commercial |
$9.52
|
| Rate for Payer: PHP Medicaid |
$4.64
|
| Rate for Payer: PHP Medicare Advantage |
$8.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.60
|
| Rate for Payer: Priority Health Medicare |
$8.65
|
| Rate for Payer: Priority Health Narrow Network |
$34.88
|
| Rate for Payer: Railroad Medicare Medicare |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.65
|
| Rate for Payer: UHC Exchange |
$13.41
|
| Rate for Payer: UHC Medicaid |
$4.52
|
| Rate for Payer: UHCCP DNSP |
$8.65
|
| Rate for Payer: UHCCP Medicaid |
$4.52
|
| Rate for Payer: VA VA |
$8.65
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,576.26
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$13,182.19 |
| Max. Negotiated Rate |
$17,576.26 |
| Rate for Payer: Aetna Commercial |
$15,818.63
|
| Rate for Payer: ASR ASR |
$17,048.97
|
| Rate for Payer: BCBS Trust/PPO |
$14,433.62
|
| Rate for Payer: BCN Commercial |
$14,433.62
|
| Rate for Payer: Cash Price |
$14,061.01
|
| Rate for Payer: Cofinity Commercial |
$16,521.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,061.01
|
| Rate for Payer: Healthscope Commercial |
$17,048.97
|
| Rate for Payer: Healthscope Whirlpool |
$17,576.26
|
| Rate for Payer: Mclaren Commercial |
$15,818.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,939.82
|
| Rate for Payer: Nomi Health Commercial |
$14,412.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,182.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,467.11
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,576.26
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,503.22 |
| Max. Negotiated Rate |
$17,576.26 |
| Rate for Payer: Aetna Commercial |
$15,818.63
|
| Rate for Payer: Aetna Medicare |
$6,503.22
|
| Rate for Payer: ASR ASR |
$17,048.97
|
| Rate for Payer: BCBS Complete |
$7,030.50
|
| Rate for Payer: BCBS Trust/PPO |
$14,491.63
|
| Rate for Payer: BCN Commercial |
$14,491.63
|
| Rate for Payer: Cash Price |
$14,061.01
|
| Rate for Payer: Cofinity Commercial |
$16,521.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,061.01
|
| Rate for Payer: Healthscope Commercial |
$17,048.97
|
| Rate for Payer: Healthscope Whirlpool |
$17,576.26
|
| Rate for Payer: Mclaren Commercial |
$15,818.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,061.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,939.82
|
| Rate for Payer: Nomi Health Commercial |
$14,412.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,182.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15,400.32
|
| Rate for Payer: Priority Health Narrow Network |
$12,320.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,467.11
|
|
