|
HC MOUSE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC MOUSE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
OP
|
$174.20
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$52.31 |
| Max. Negotiated Rate |
$553.60 |
| Rate for Payer: Aetna Commercial |
$156.78
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$168.97
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$143.63
|
| Rate for Payer: BCN Commercial |
$143.63
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$139.36
|
| Rate for Payer: Cash Price |
$139.36
|
| Rate for Payer: Cofinity Commercial |
$163.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$168.97
|
| Rate for Payer: Healthscope Whirlpool |
$174.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$156.78
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.07
|
| Rate for Payer: Nomi Health Commercial |
$142.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.65
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
IP
|
$174.20
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$130.65 |
| Max. Negotiated Rate |
$174.20 |
| Rate for Payer: Aetna Commercial |
$156.78
|
| Rate for Payer: ASR ASR |
$168.97
|
| Rate for Payer: BCBS Trust/PPO |
$143.05
|
| Rate for Payer: BCN Commercial |
$143.05
|
| Rate for Payer: Cash Price |
$139.36
|
| Rate for Payer: Cofinity Commercial |
$163.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.36
|
| Rate for Payer: Healthscope Commercial |
$168.97
|
| Rate for Payer: Healthscope Whirlpool |
$174.20
|
| Rate for Payer: Mclaren Commercial |
$156.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.07
|
| Rate for Payer: Nomi Health Commercial |
$142.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.30
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
IP
|
$54.86
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$41.15 |
| Max. Negotiated Rate |
$54.86 |
| Rate for Payer: Aetna Commercial |
$49.37
|
| Rate for Payer: ASR ASR |
$53.21
|
| Rate for Payer: BCBS Trust/PPO |
$45.05
|
| Rate for Payer: BCN Commercial |
$45.05
|
| Rate for Payer: Cash Price |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$51.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.89
|
| Rate for Payer: Healthscope Commercial |
$53.21
|
| Rate for Payer: Healthscope Whirlpool |
$54.86
|
| Rate for Payer: Mclaren Commercial |
$49.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.63
|
| Rate for Payer: Nomi Health Commercial |
$44.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.28
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
OP
|
$54.86
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.30 |
| Max. Negotiated Rate |
$65.38 |
| Rate for Payer: Aetna Commercial |
$49.37
|
| Rate for Payer: Aetna Medicare |
$20.30
|
| Rate for Payer: ASR ASR |
$53.21
|
| Rate for Payer: BCBS Complete |
$21.94
|
| Rate for Payer: BCBS Trust/PPO |
$45.23
|
| Rate for Payer: BCN Commercial |
$45.23
|
| Rate for Payer: Cash Price |
$43.89
|
| Rate for Payer: Cash Price |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$51.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.89
|
| Rate for Payer: Healthscope Commercial |
$53.21
|
| Rate for Payer: Healthscope Whirlpool |
$54.86
|
| Rate for Payer: Mclaren Commercial |
$49.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.63
|
| Rate for Payer: Nomi Health Commercial |
$44.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.28
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
OP
|
$387.35
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$96.86 |
| Max. Negotiated Rate |
$387.35 |
| Rate for Payer: Aetna Commercial |
$348.62
|
| Rate for Payer: Aetna Medicare |
$185.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.50
|
| Rate for Payer: ASR ASR |
$375.73
|
| Rate for Payer: BCBS Complete |
$101.71
|
| Rate for Payer: BCBS MAPPO |
$185.20
|
| Rate for Payer: BCBS Trust/PPO |
$319.37
|
| Rate for Payer: BCN Commercial |
$319.37
|
| Rate for Payer: BCN Medicare Advantage |
$185.20
|
| Rate for Payer: Cash Price |
$309.88
|
| Rate for Payer: Cash Price |
$309.88
|
| Rate for Payer: Cofinity Commercial |
$364.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.20
|
| Rate for Payer: Healthscope Commercial |
$375.73
|
| Rate for Payer: Healthscope Whirlpool |
$387.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$185.20
|
| Rate for Payer: Mclaren Commercial |
$348.62
|
| Rate for Payer: Mclaren Medicaid |
$185.20
|
| Rate for Payer: Mclaren Medicare |
$185.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.46
|
| Rate for Payer: Meridian Medicaid |
$101.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.25
|
| Rate for Payer: Nomi Health Commercial |
$317.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.51
|
| Rate for Payer: PACE Medicare |
$175.94
|
| Rate for Payer: PACE SWMI |
$185.20
|
| Rate for Payer: PHP Commercial |
$203.72
|
| Rate for Payer: PHP Medicaid |
$99.27
|
| Rate for Payer: PHP Medicare Advantage |
$185.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$339.40
|
| Rate for Payer: Priority Health Medicare |
$185.20
|
| Rate for Payer: Priority Health Narrow Network |
$271.53
|
| Rate for Payer: Railroad Medicare Medicare |
$185.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.20
|
| Rate for Payer: UHC Exchange |
$287.06
|
| Rate for Payer: UHC Medicaid |
$96.86
|
| Rate for Payer: UHCCP DNSP |
$185.20
|
| Rate for Payer: UHCCP Medicaid |
$96.86
|
| Rate for Payer: VA VA |
$185.20
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
IP
|
$387.35
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$290.51 |
| Max. Negotiated Rate |
$387.35 |
| Rate for Payer: Aetna Commercial |
$348.62
|
| Rate for Payer: ASR ASR |
$375.73
|
| Rate for Payer: BCBS Trust/PPO |
$318.09
|
| Rate for Payer: BCN Commercial |
$318.09
|
| Rate for Payer: Cash Price |
$309.88
|
| Rate for Payer: Cofinity Commercial |
$364.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.88
|
| Rate for Payer: Healthscope Commercial |
$375.73
|
| Rate for Payer: Healthscope Whirlpool |
$387.35
|
| Rate for Payer: Mclaren Commercial |
$348.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.25
|
| Rate for Payer: Nomi Health Commercial |
$317.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.87
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
OP
|
$612.32
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$156.90 |
| Max. Negotiated Rate |
$612.32 |
| Rate for Payer: Aetna Commercial |
$551.09
|
| Rate for Payer: Aetna Medicare |
$300.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.00
|
| Rate for Payer: ASR ASR |
$593.95
|
| Rate for Payer: BCBS Complete |
$164.76
|
| Rate for Payer: BCBS MAPPO |
$300.00
|
| Rate for Payer: BCBS Trust/PPO |
$504.86
|
| Rate for Payer: BCN Commercial |
$504.86
|
| Rate for Payer: BCN Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$489.86
|
| Rate for Payer: Cash Price |
$489.86
|
| Rate for Payer: Cofinity Commercial |
$575.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$593.95
|
| Rate for Payer: Healthscope Whirlpool |
$612.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$300.00
|
| Rate for Payer: Mclaren Commercial |
$551.09
|
| Rate for Payer: Mclaren Medicaid |
$300.00
|
| Rate for Payer: Mclaren Medicare |
$300.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.00
|
| Rate for Payer: Meridian Medicaid |
$164.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$330.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.47
|
| Rate for Payer: Nomi Health Commercial |
$502.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.24
|
| Rate for Payer: PACE Medicare |
$285.00
|
| Rate for Payer: PACE SWMI |
$300.00
|
| Rate for Payer: PHP Commercial |
$330.00
|
| Rate for Payer: PHP Medicaid |
$160.80
|
| Rate for Payer: PHP Medicare Advantage |
$300.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$536.51
|
| Rate for Payer: Priority Health Medicare |
$300.00
|
| Rate for Payer: Priority Health Narrow Network |
$429.24
|
| Rate for Payer: Railroad Medicare Medicare |
$300.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$300.00
|
| Rate for Payer: UHC Exchange |
$465.00
|
| Rate for Payer: UHC Medicaid |
$156.90
|
| Rate for Payer: UHCCP DNSP |
$300.00
|
| Rate for Payer: UHCCP Medicaid |
$156.90
|
| Rate for Payer: VA VA |
$300.00
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
IP
|
$612.32
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$459.24 |
| Max. Negotiated Rate |
$612.32 |
| Rate for Payer: Aetna Commercial |
$551.09
|
| Rate for Payer: ASR ASR |
$593.95
|
| Rate for Payer: BCBS Trust/PPO |
$502.84
|
| Rate for Payer: BCN Commercial |
$502.84
|
| Rate for Payer: Cash Price |
$489.86
|
| Rate for Payer: Cofinity Commercial |
$575.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.86
|
| Rate for Payer: Healthscope Commercial |
$593.95
|
| Rate for Payer: Healthscope Whirlpool |
$612.32
|
| Rate for Payer: Mclaren Commercial |
$551.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.47
|
| Rate for Payer: Nomi Health Commercial |
$502.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.84
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
IP
|
$661.13
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$495.85 |
| Max. Negotiated Rate |
$661.13 |
| Rate for Payer: Aetna Commercial |
$595.02
|
| Rate for Payer: ASR ASR |
$641.30
|
| Rate for Payer: BCBS Trust/PPO |
$542.92
|
| Rate for Payer: BCN Commercial |
$542.92
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cofinity Commercial |
$621.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.90
|
| Rate for Payer: Healthscope Commercial |
$641.30
|
| Rate for Payer: Healthscope Whirlpool |
$661.13
|
| Rate for Payer: Mclaren Commercial |
$595.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$561.96
|
| Rate for Payer: Nomi Health Commercial |
$542.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$495.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$581.79
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
OP
|
$661.13
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.61 |
| Max. Negotiated Rate |
$661.13 |
| Rate for Payer: Aetna Commercial |
$595.02
|
| Rate for Payer: Aetna Medicare |
$121.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: ASR ASR |
$641.30
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$545.10
|
| Rate for Payer: BCN Commercial |
$545.10
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cash Price |
$528.90
|
| Rate for Payer: Cofinity Commercial |
$621.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$641.30
|
| Rate for Payer: Healthscope Whirlpool |
$661.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$121.63
|
| Rate for Payer: Mclaren Commercial |
$595.02
|
| Rate for Payer: Mclaren Medicaid |
$121.63
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: Meridian Medicaid |
$66.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$561.96
|
| Rate for Payer: Nomi Health Commercial |
$542.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$495.85
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$133.79
|
| Rate for Payer: PHP Medicaid |
$65.19
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$579.28
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health Narrow Network |
$463.45
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$581.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.63
|
| Rate for Payer: UHC Exchange |
$188.53
|
| Rate for Payer: UHC Medicaid |
$63.61
|
| Rate for Payer: UHCCP DNSP |
$121.63
|
| Rate for Payer: UHCCP Medicaid |
$63.61
|
| Rate for Payer: VA VA |
$121.63
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
OP
|
$420.24
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.94 |
| Max. Negotiated Rate |
$420.24 |
| Rate for Payer: Aetna Commercial |
$378.22
|
| Rate for Payer: Aetna Medicare |
$91.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.58
|
| Rate for Payer: ASR ASR |
$407.63
|
| Rate for Payer: BCBS Complete |
$50.34
|
| Rate for Payer: BCBS MAPPO |
$91.66
|
| Rate for Payer: BCBS Trust/PPO |
$346.49
|
| Rate for Payer: BCN Commercial |
$346.49
|
| Rate for Payer: BCN Medicare Advantage |
$91.66
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cofinity Commercial |
$395.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.66
|
| Rate for Payer: Healthscope Commercial |
$407.63
|
| Rate for Payer: Healthscope Whirlpool |
$420.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$91.66
|
| Rate for Payer: Mclaren Commercial |
$378.22
|
| Rate for Payer: Mclaren Medicaid |
$91.66
|
| Rate for Payer: Mclaren Medicare |
$91.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.24
|
| Rate for Payer: Meridian Medicaid |
$50.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.20
|
| Rate for Payer: Nomi Health Commercial |
$344.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.18
|
| Rate for Payer: PACE Medicare |
$87.08
|
| Rate for Payer: PACE SWMI |
$91.66
|
| Rate for Payer: PHP Commercial |
$100.83
|
| Rate for Payer: PHP Medicaid |
$49.13
|
| Rate for Payer: PHP Medicare Advantage |
$91.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.92
|
| Rate for Payer: Priority Health Medicare |
$91.66
|
| Rate for Payer: Priority Health Narrow Network |
$52.74
|
| Rate for Payer: Railroad Medicare Medicare |
$91.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.66
|
| Rate for Payer: UHC Exchange |
$142.07
|
| Rate for Payer: UHC Medicaid |
$47.94
|
| Rate for Payer: UHCCP DNSP |
$91.66
|
| Rate for Payer: UHCCP Medicaid |
$47.94
|
| Rate for Payer: VA VA |
$91.66
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
IP
|
$420.24
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$315.18 |
| Max. Negotiated Rate |
$420.24 |
| Rate for Payer: Aetna Commercial |
$378.22
|
| Rate for Payer: ASR ASR |
$407.63
|
| Rate for Payer: BCBS Trust/PPO |
$345.10
|
| Rate for Payer: BCN Commercial |
$345.10
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cofinity Commercial |
$395.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.19
|
| Rate for Payer: Healthscope Commercial |
$407.63
|
| Rate for Payer: Healthscope Whirlpool |
$420.24
|
| Rate for Payer: Mclaren Commercial |
$378.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.20
|
| Rate for Payer: Nomi Health Commercial |
$344.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.81
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
OP
|
$2,412.01
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,412.01 |
| Rate for Payer: Aetna Commercial |
$2,170.81
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$2,339.65
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,988.70
|
| Rate for Payer: BCN Commercial |
$1,988.70
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,929.61
|
| Rate for Payer: Cash Price |
$1,929.61
|
| Rate for Payer: Cofinity Commercial |
$2,267.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,929.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,339.65
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,170.81
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,050.21
|
| Rate for Payer: Nomi Health Commercial |
$1,977.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.01
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,866.69
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.35
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,122.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
IP
|
$2,412.01
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,809.01 |
| Max. Negotiated Rate |
$2,412.01 |
| Rate for Payer: Aetna Commercial |
$2,170.81
|
| Rate for Payer: ASR ASR |
$2,339.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,980.74
|
| Rate for Payer: BCN Commercial |
$1,980.74
|
| Rate for Payer: Cash Price |
$1,929.61
|
| Rate for Payer: Cofinity Commercial |
$2,267.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,929.61
|
| Rate for Payer: Healthscope Commercial |
$2,339.65
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.01
|
| Rate for Payer: Mclaren Commercial |
$2,170.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,050.21
|
| Rate for Payer: Nomi Health Commercial |
$1,977.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,122.57
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
IP
|
$2,152.66
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,614.49 |
| Max. Negotiated Rate |
$2,152.66 |
| Rate for Payer: Aetna Commercial |
$1,937.39
|
| Rate for Payer: ASR ASR |
$2,088.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,767.76
|
| Rate for Payer: BCN Commercial |
$1,767.76
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cofinity Commercial |
$2,023.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.13
|
| Rate for Payer: Healthscope Commercial |
$2,088.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,152.66
|
| Rate for Payer: Mclaren Commercial |
$1,937.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,829.76
|
| Rate for Payer: Nomi Health Commercial |
$1,765.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,614.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,894.34
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
OP
|
$2,152.66
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,152.66 |
| Rate for Payer: Aetna Commercial |
$1,937.39
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$2,088.08
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,774.87
|
| Rate for Payer: BCN Commercial |
$1,774.87
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cash Price |
$1,722.13
|
| Rate for Payer: Cofinity Commercial |
$2,023.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,088.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,152.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,937.39
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,829.76
|
| Rate for Payer: Nomi Health Commercial |
$1,765.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,614.49
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,682.06
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.65
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,894.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
OP
|
$3,152.11
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,152.11 |
| Rate for Payer: Aetna Commercial |
$2,836.90
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$3,057.55
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,598.91
|
| Rate for Payer: BCN Commercial |
$2,598.91
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,521.69
|
| Rate for Payer: Cash Price |
$2,521.69
|
| Rate for Payer: Cofinity Commercial |
$2,962.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,521.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,057.55
|
| Rate for Payer: Healthscope Whirlpool |
$3,152.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,836.90
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,679.29
|
| Rate for Payer: Nomi Health Commercial |
$2,584.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.08
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,275.85
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,820.68
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,773.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
IP
|
$3,152.11
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,364.08 |
| Max. Negotiated Rate |
$3,152.11 |
| Rate for Payer: Aetna Commercial |
$2,836.90
|
| Rate for Payer: ASR ASR |
$3,057.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,588.51
|
| Rate for Payer: BCN Commercial |
$2,588.51
|
| Rate for Payer: Cash Price |
$2,521.69
|
| Rate for Payer: Cofinity Commercial |
$2,962.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,521.69
|
| Rate for Payer: Healthscope Commercial |
$3,057.55
|
| Rate for Payer: Healthscope Whirlpool |
$3,152.11
|
| Rate for Payer: Mclaren Commercial |
$2,836.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,679.29
|
| Rate for Payer: Nomi Health Commercial |
$2,584.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,773.86
|
|
|
HC MRA HEAD WO CON
|
Facility
|
IP
|
$1,845.38
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,384.04 |
| Max. Negotiated Rate |
$1,845.38 |
| Rate for Payer: Aetna Commercial |
$1,660.84
|
| Rate for Payer: ASR ASR |
$1,790.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.43
|
| Rate for Payer: BCN Commercial |
$1,515.43
|
| Rate for Payer: Cash Price |
$1,476.30
|
| Rate for Payer: Cofinity Commercial |
$1,734.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,476.30
|
| Rate for Payer: Healthscope Commercial |
$1,790.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,845.38
|
| Rate for Payer: Mclaren Commercial |
$1,660.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,568.57
|
| Rate for Payer: Nomi Health Commercial |
$1,513.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,623.93
|
|
|
HC MRA HEAD WO CON
|
Facility
|
OP
|
$1,845.38
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,845.38 |
| Rate for Payer: Aetna Commercial |
$1,660.84
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,790.02
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,521.52
|
| Rate for Payer: BCN Commercial |
$1,521.52
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,476.30
|
| Rate for Payer: Cash Price |
$1,476.30
|
| Rate for Payer: Cofinity Commercial |
$1,734.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,476.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,790.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,845.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,660.84
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,568.57
|
| Rate for Payer: Nomi Health Commercial |
$1,513.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.04
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,446.62
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.29
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,623.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
OP
|
$3,113.86
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,113.86 |
| Rate for Payer: Aetna Commercial |
$2,802.47
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$3,020.44
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,567.38
|
| Rate for Payer: BCN Commercial |
$2,567.38
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Commercial |
$2,927.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,020.44
|
| Rate for Payer: Healthscope Whirlpool |
$3,113.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$2,802.47
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$2,553.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,381.77
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,905.41
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,740.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
IP
|
$3,113.86
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,335.39 |
| Max. Negotiated Rate |
$3,113.86 |
| Rate for Payer: Aetna Commercial |
$2,802.47
|
| Rate for Payer: ASR ASR |
$3,020.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,557.10
|
| Rate for Payer: BCN Commercial |
$2,557.10
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Commercial |
$2,927.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Healthscope Commercial |
$3,020.44
|
| Rate for Payer: Healthscope Whirlpool |
$3,113.86
|
| Rate for Payer: Mclaren Commercial |
$2,802.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$2,553.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,740.20
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
IP
|
$1,440.80
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,080.60 |
| Max. Negotiated Rate |
$1,440.80 |
| Rate for Payer: Aetna Commercial |
$1,296.72
|
| Rate for Payer: ASR ASR |
$1,397.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.18
|
| Rate for Payer: BCN Commercial |
$1,183.18
|
| Rate for Payer: Cash Price |
$1,152.64
|
| Rate for Payer: Cofinity Commercial |
$1,354.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.64
|
| Rate for Payer: Healthscope Commercial |
$1,397.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,440.80
|
| Rate for Payer: Mclaren Commercial |
$1,296.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.68
|
| Rate for Payer: Nomi Health Commercial |
$1,181.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,267.90
|
|
