|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$79.56 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$179.01
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: ASR ASR |
$192.93
|
| Rate for Payer: ASR Commercial |
$192.93
|
| Rate for Payer: BCBS Complete |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$162.88
|
| Rate for Payer: BCN Commercial |
$154.21
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$186.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Healthscope Whirlpool |
$192.93
|
| Rate for Payer: Mclaren Commercial |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.28
|
| Rate for Payer: Priority Health Narrow Network |
$139.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.03
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.28 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$179.01
|
| Rate for Payer: ASR ASR |
$192.93
|
| Rate for Payer: ASR Commercial |
$192.93
|
| Rate for Payer: BCBS Trust/PPO |
$162.08
|
| Rate for Payer: BCN Commercial |
$154.21
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$186.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Healthscope Whirlpool |
$192.93
|
| Rate for Payer: Mclaren Commercial |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.03
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,925.53
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,901.59 |
| Max. Negotiated Rate |
$5,526.85 |
| Rate for Payer: Aetna Commercial |
$2,632.98
|
| Rate for Payer: Aetna Medicare |
$3,565.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: ASR ASR |
$2,837.76
|
| Rate for Payer: ASR Commercial |
$2,837.76
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,395.72
|
| Rate for Payer: BCN Commercial |
$2,268.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$2,340.42
|
| Rate for Payer: Cash Price |
$2,340.42
|
| Rate for Payer: Cofinity Commercial |
$2,750.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,340.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$2,925.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,837.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,565.71
|
| Rate for Payer: Mclaren Commercial |
$2,632.98
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,486.70
|
| Rate for Payer: Nomi Health Commercial |
$2,398.93
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$3,922.28
|
| Rate for Payer: PHP Medicaid |
$1,911.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,901.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,563.35
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,050.80
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,574.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$5,526.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP DNSP |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: VA VA |
$3,565.71
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,925.53
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,901.59 |
| Max. Negotiated Rate |
$2,925.53 |
| Rate for Payer: Aetna Commercial |
$2,632.98
|
| Rate for Payer: ASR ASR |
$2,837.76
|
| Rate for Payer: ASR Commercial |
$2,837.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,384.01
|
| Rate for Payer: BCN Commercial |
$2,268.16
|
| Rate for Payer: Cash Price |
$2,340.42
|
| Rate for Payer: Cofinity Commercial |
$2,750.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,340.42
|
| Rate for Payer: Healthscope Commercial |
$2,925.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,837.76
|
| Rate for Payer: Mclaren Commercial |
$2,632.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,486.70
|
| Rate for Payer: Nomi Health Commercial |
$2,398.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,901.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,574.47
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,704.87
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,911.22 |
| Max. Negotiated Rate |
$5,526.85 |
| Rate for Payer: Aetna Commercial |
$3,334.38
|
| Rate for Payer: Aetna Medicare |
$3,565.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: ASR ASR |
$3,593.72
|
| Rate for Payer: ASR Commercial |
$3,593.72
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,033.92
|
| Rate for Payer: BCN Commercial |
$2,872.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$2,963.90
|
| Rate for Payer: Cash Price |
$2,963.90
|
| Rate for Payer: Cofinity Commercial |
$3,482.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,963.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$3,704.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,593.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,565.71
|
| Rate for Payer: Mclaren Commercial |
$3,334.38
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,149.14
|
| Rate for Payer: Nomi Health Commercial |
$3,037.99
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$3,922.28
|
| Rate for Payer: PHP Medicaid |
$1,911.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,246.21
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,597.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,260.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$5,526.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP DNSP |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: VA VA |
$3,565.71
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,704.87
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,408.17 |
| Max. Negotiated Rate |
$3,704.87 |
| Rate for Payer: Aetna Commercial |
$3,334.38
|
| Rate for Payer: ASR ASR |
$3,593.72
|
| Rate for Payer: ASR Commercial |
$3,593.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,019.10
|
| Rate for Payer: BCN Commercial |
$2,872.39
|
| Rate for Payer: Cash Price |
$2,963.90
|
| Rate for Payer: Cofinity Commercial |
$3,482.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,963.90
|
| Rate for Payer: Healthscope Commercial |
$3,704.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,593.72
|
| Rate for Payer: Mclaren Commercial |
$3,334.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,149.14
|
| Rate for Payer: Nomi Health Commercial |
$3,037.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,260.29
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.98 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: ASR Commercial |
$93.99
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: Aetna Medicare |
$21.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: ASR Commercial |
$93.99
|
| Rate for Payer: BCBS Complete |
$12.38
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$79.35
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Mclaren Medicaid |
$11.79
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$24.19
|
| Rate for Payer: PHP Medicaid |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.90
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health Narrow Network |
$67.93
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.99
|
| Rate for Payer: UHC Exchange |
$34.08
|
| Rate for Payer: UHC Medicare Advantage |
$21.99
|
| Rate for Payer: UHCCP DNSP |
$21.99
|
| Rate for Payer: UHCCP Medicaid |
$11.79
|
| Rate for Payer: VA VA |
$21.99
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$29,495.34
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,171.97 |
| Max. Negotiated Rate |
$29,495.34 |
| Rate for Payer: Aetna Commercial |
$26,545.81
|
| Rate for Payer: ASR ASR |
$28,610.48
|
| Rate for Payer: ASR Commercial |
$28,610.48
|
| Rate for Payer: BCBS Trust/PPO |
$24,035.75
|
| Rate for Payer: BCN Commercial |
$22,867.74
|
| Rate for Payer: Cash Price |
$23,596.27
|
| Rate for Payer: Cofinity Commercial |
$27,725.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,596.27
|
| Rate for Payer: Healthscope Commercial |
$29,495.34
|
| Rate for Payer: Healthscope Whirlpool |
$28,610.48
|
| Rate for Payer: Mclaren Commercial |
$26,545.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,071.04
|
| Rate for Payer: Nomi Health Commercial |
$24,186.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,171.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,955.90
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$29,495.34
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,798.14 |
| Max. Negotiated Rate |
$29,495.34 |
| Rate for Payer: Aetna Commercial |
$26,545.81
|
| Rate for Payer: Aetna Medicare |
$14,747.67
|
| Rate for Payer: ASR ASR |
$28,610.48
|
| Rate for Payer: ASR Commercial |
$28,610.48
|
| Rate for Payer: BCBS Complete |
$11,798.14
|
| Rate for Payer: BCBS Trust/PPO |
$24,153.73
|
| Rate for Payer: BCN Commercial |
$22,867.74
|
| Rate for Payer: Cash Price |
$23,596.27
|
| Rate for Payer: Cofinity Commercial |
$27,725.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,596.27
|
| Rate for Payer: Healthscope Commercial |
$29,495.34
|
| Rate for Payer: Healthscope Whirlpool |
$28,610.48
|
| Rate for Payer: Mclaren Commercial |
$26,545.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,071.04
|
| Rate for Payer: Nomi Health Commercial |
$24,186.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,171.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,843.82
|
| Rate for Payer: Priority Health Narrow Network |
$20,676.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,955.90
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$9,854.02
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.13 |
| Max. Negotiated Rate |
$9,854.02 |
| Rate for Payer: Aetna Commercial |
$8,868.62
|
| Rate for Payer: Aetna Medicare |
$3,151.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: ASR ASR |
$9,558.40
|
| Rate for Payer: ASR Commercial |
$9,558.40
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$8,069.46
|
| Rate for Payer: BCN Commercial |
$7,639.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$7,883.22
|
| Rate for Payer: Cash Price |
$7,883.22
|
| Rate for Payer: Cofinity Commercial |
$9,262.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,883.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$9,854.02
|
| Rate for Payer: Healthscope Whirlpool |
$9,558.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,151.37
|
| Rate for Payer: Mclaren Commercial |
$8,868.62
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,375.92
|
| Rate for Payer: Nomi Health Commercial |
$8,080.30
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$3,466.51
|
| Rate for Payer: PHP Medicaid |
$1,689.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,405.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,634.09
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$6,907.67
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,671.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$4,884.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP DNSP |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,689.13
|
| Rate for Payer: VA VA |
$3,151.37
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$9,854.02
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,405.11 |
| Max. Negotiated Rate |
$9,854.02 |
| Rate for Payer: Aetna Commercial |
$8,868.62
|
| Rate for Payer: ASR ASR |
$9,558.40
|
| Rate for Payer: ASR Commercial |
$9,558.40
|
| Rate for Payer: BCBS Trust/PPO |
$8,030.04
|
| Rate for Payer: BCN Commercial |
$7,639.82
|
| Rate for Payer: Cash Price |
$7,883.22
|
| Rate for Payer: Cofinity Commercial |
$9,262.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,883.22
|
| Rate for Payer: Healthscope Commercial |
$9,854.02
|
| Rate for Payer: Healthscope Whirlpool |
$9,558.40
|
| Rate for Payer: Mclaren Commercial |
$8,868.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,375.92
|
| Rate for Payer: Nomi Health Commercial |
$8,080.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,405.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,671.54
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: ASR Commercial |
$97.00
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.36
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: ASR Commercial |
$97.00
|
| Rate for Payer: BCBS Complete |
$5.12
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCBS Trust/PPO |
$81.89
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.09
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Mclaren Medicaid |
$4.87
|
| Rate for Payer: Mclaren Medicare |
$9.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Meridian Medicaid |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.45
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: PACE Medicare |
$8.64
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Commercial |
$10.00
|
| Rate for Payer: PHP Medicaid |
$4.87
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.63
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: Priority Health Narrow Network |
$10.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Exchange |
$14.09
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
| Rate for Payer: UHCCP DNSP |
$9.09
|
| Rate for Payer: UHCCP Medicaid |
$4.87
|
| Rate for Payer: VA VA |
$9.09
|
|
|
HC LEGIONELLA
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$41.75
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC LEGIONELLA AG
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$41.75
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC LEGIONELLA AG
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$41.75
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
OP
|
$109.75
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$109.75 |
| Rate for Payer: Aetna Commercial |
$98.78
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$106.46
|
| Rate for Payer: ASR Commercial |
$106.46
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$89.87
|
| Rate for Payer: BCN Commercial |
$85.09
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$103.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$109.75
|
| Rate for Payer: Healthscope Whirlpool |
$106.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$98.78
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: Nomi Health Commercial |
$90.00
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.16
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$76.93
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
IP
|
$109.75
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.34 |
| Max. Negotiated Rate |
$109.75 |
| Rate for Payer: Aetna Commercial |
$98.78
|
| Rate for Payer: ASR ASR |
$106.46
|
| Rate for Payer: ASR Commercial |
$106.46
|
| Rate for Payer: BCBS Trust/PPO |
$89.44
|
| Rate for Payer: BCN Commercial |
$85.09
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$103.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Healthscope Commercial |
$109.75
|
| Rate for Payer: Healthscope Whirlpool |
$106.46
|
| Rate for Payer: Mclaren Commercial |
$98.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: Nomi Health Commercial |
$90.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.58
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: ASR Commercial |
$121.10
|
| Rate for Payer: BCBS Trust/PPO |
$101.74
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$124.85
|
| Rate for Payer: Healthscope Whirlpool |
$121.10
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| 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 |
$121.10
|
| Rate for Payer: ASR Commercial |
$121.10
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$102.24
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$124.85
|
| Rate for Payer: Healthscope Whirlpool |
$121.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| 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 |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| 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 |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.39
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$87.52
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC LEGIONELLA PNEUMOPHILA AB
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200301
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$83.45 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: ASR Commercial |
$47.49
|
| Rate for Payer: BCBS Complete |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$40.09
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicaid |
$8.20
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.45
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$66.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$23.72
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP DNSP |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$8.20
|
| Rate for Payer: VA VA |
$15.30
|
|
