|
HC LEVETIRACETAM LEVEL
|
Facility
|
OP
|
$76.79
|
|
|
Service Code
|
CPT 80177
|
| Hospital Charge Code |
30100057
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$76.79 |
| Rate for Payer: Aetna Commercial |
$69.11
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$74.49
|
| Rate for Payer: ASR Commercial |
$74.49
|
| Rate for Payer: BCBS Complete |
$7.46
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$62.88
|
| Rate for Payer: BCN Commercial |
$59.54
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$61.43
|
| Rate for Payer: Cash Price |
$61.43
|
| Rate for Payer: Cofinity Commercial |
$72.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$76.79
|
| Rate for Payer: Healthscope Whirlpool |
$74.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$69.11
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.27
|
| Rate for Payer: Nomi Health Commercial |
$62.97
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.58
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.72
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$16.58
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Exchange |
$20.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
| Rate for Payer: UHCCP DNSP |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC LEVONORGESTREL-RELEASING ICS, 52MG, 5 YR
|
Facility
|
OP
|
$3,846.72
|
|
|
Service Code
|
CPT J7298
|
| Hospital Charge Code |
63600106
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$991.14 |
| Max. Negotiated Rate |
$3,846.72 |
| Rate for Payer: Aetna Commercial |
$3,462.05
|
| Rate for Payer: Aetna Medicare |
$1,923.36
|
| Rate for Payer: ASR ASR |
$3,731.32
|
| Rate for Payer: ASR Commercial |
$3,731.32
|
| Rate for Payer: BCBS Complete |
$1,538.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,150.08
|
| Rate for Payer: BCN Commercial |
$2,982.36
|
| Rate for Payer: Cash Price |
$3,077.38
|
| Rate for Payer: Cash Price |
$3,077.38
|
| Rate for Payer: Cofinity Commercial |
$3,615.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,077.38
|
| Rate for Payer: Healthscope Commercial |
$3,846.72
|
| Rate for Payer: Healthscope Whirlpool |
$3,731.32
|
| Rate for Payer: Mclaren Commercial |
$3,462.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,269.71
|
| Rate for Payer: Nomi Health Commercial |
$3,154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.93
|
| Rate for Payer: Priority Health Narrow Network |
$991.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,385.11
|
|
|
HC LEVONORGESTREL-RELEASING ICS, 52MG, 5 YR
|
Facility
|
IP
|
$3,846.72
|
|
|
Service Code
|
CPT J7298
|
| Hospital Charge Code |
63600106
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,500.37 |
| Max. Negotiated Rate |
$3,846.72 |
| Rate for Payer: Aetna Commercial |
$3,462.05
|
| Rate for Payer: ASR ASR |
$3,731.32
|
| Rate for Payer: ASR Commercial |
$3,731.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,134.69
|
| Rate for Payer: BCN Commercial |
$2,982.36
|
| Rate for Payer: Cash Price |
$3,077.38
|
| Rate for Payer: Cofinity Commercial |
$3,615.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,077.38
|
| Rate for Payer: Healthscope Commercial |
$3,846.72
|
| Rate for Payer: Healthscope Whirlpool |
$3,731.32
|
| Rate for Payer: Mclaren Commercial |
$3,462.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,269.71
|
| Rate for Payer: Nomi Health Commercial |
$3,154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,385.11
|
|
|
HC LH (LUTEINIZING HORMONE)
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$18.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.52
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Medicaid |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.12
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.52
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: UHCCP DNSP |
$18.52
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$18.52
|
|
|
HC LH (LUTEINIZING HORMONE)
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC LH PEDS, S
|
Facility
|
IP
|
$183.60
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100738
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.34 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$165.24
|
| Rate for Payer: ASR ASR |
$178.09
|
| Rate for Payer: ASR Commercial |
$178.09
|
| Rate for Payer: BCBS Trust/PPO |
$149.62
|
| Rate for Payer: BCN Commercial |
$142.35
|
| Rate for Payer: Cash Price |
$146.88
|
| Rate for Payer: Cofinity Commercial |
$172.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.88
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Healthscope Whirlpool |
$178.09
|
| Rate for Payer: Mclaren Commercial |
$165.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.06
|
| Rate for Payer: Nomi Health Commercial |
$150.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.57
|
|
|
HC LH PEDS, S
|
Facility
|
OP
|
$183.60
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100738
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$165.24
|
| Rate for Payer: Aetna Medicare |
$18.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: ASR ASR |
$178.09
|
| Rate for Payer: ASR Commercial |
$178.09
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$150.35
|
| Rate for Payer: BCN Commercial |
$142.35
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$146.88
|
| Rate for Payer: Cash Price |
$146.88
|
| Rate for Payer: Cofinity Commercial |
$172.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Healthscope Whirlpool |
$178.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.52
|
| Rate for Payer: Mclaren Commercial |
$165.24
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.06
|
| Rate for Payer: Nomi Health Commercial |
$150.55
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Medicaid |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.12
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.52
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: UHCCP DNSP |
$18.52
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$18.52
|
|
|
HC LH ULTRASENSITIVE
|
Facility
|
OP
|
$79.07
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$71.16
|
| Rate for Payer: Aetna Medicare |
$18.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: ASR ASR |
$76.70
|
| Rate for Payer: ASR Commercial |
$76.70
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$64.75
|
| Rate for Payer: BCN Commercial |
$61.30
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$79.07
|
| Rate for Payer: Healthscope Whirlpool |
$76.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.52
|
| Rate for Payer: Mclaren Commercial |
$71.16
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Medicaid |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.12
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.52
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: UHCCP DNSP |
$18.52
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$18.52
|
|
|
HC LH ULTRASENSITIVE
|
Facility
|
IP
|
$79.07
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.40 |
| Max. Negotiated Rate |
$79.07 |
| Rate for Payer: Aetna Commercial |
$71.16
|
| Rate for Payer: ASR ASR |
$76.70
|
| Rate for Payer: ASR Commercial |
$76.70
|
| Rate for Payer: BCBS Trust/PPO |
$64.43
|
| Rate for Payer: BCN Commercial |
$61.30
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Healthscope Commercial |
$79.07
|
| Rate for Payer: Healthscope Whirlpool |
$76.70
|
| Rate for Payer: Mclaren Commercial |
$71.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.58
|
|
|
HC LIDOCAINE XYLOCAINE LEVEL
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
30100033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC LIDOCAINE XYLOCAINE LEVEL
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
30100033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$14.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.69
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$14.69
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.69
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.42
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$13.96
|
| Rate for Payer: PACE SWMI |
$14.69
|
| Rate for Payer: PHP Commercial |
$16.16
|
| Rate for Payer: PHP Medicaid |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.09
|
| Rate for Payer: Priority Health Medicare |
$14.69
|
| Rate for Payer: Priority Health Narrow Network |
$46.48
|
| Rate for Payer: Railroad Medicare Medicare |
$14.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.69
|
| Rate for Payer: UHC Exchange |
$22.77
|
| Rate for Payer: UHC Medicare Advantage |
$14.69
|
| Rate for Payer: UHCCP DNSP |
$14.69
|
| Rate for Payer: UHCCP Medicaid |
$7.87
|
| Rate for Payer: VA VA |
$14.69
|
|
|
HC LIMITED SPECTRAL DOPPLER
|
Facility
|
IP
|
$375.77
|
|
|
Service Code
|
HCPCS 93321
|
| Hospital Charge Code |
48000025
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$244.25 |
| Max. Negotiated Rate |
$375.77 |
| Rate for Payer: Aetna Commercial |
$338.19
|
| Rate for Payer: ASR ASR |
$364.50
|
| Rate for Payer: ASR Commercial |
$364.50
|
| Rate for Payer: BCBS Trust/PPO |
$306.21
|
| Rate for Payer: BCN Commercial |
$291.33
|
| Rate for Payer: Cash Price |
$300.62
|
| Rate for Payer: Cofinity Commercial |
$353.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.62
|
| Rate for Payer: Healthscope Commercial |
$375.77
|
| Rate for Payer: Healthscope Whirlpool |
$364.50
|
| Rate for Payer: Mclaren Commercial |
$338.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.40
|
| Rate for Payer: Nomi Health Commercial |
$308.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.68
|
|
|
HC LIMITED SPECTRAL DOPPLER
|
Facility
|
OP
|
$375.77
|
|
|
Service Code
|
HCPCS 93321
|
| Hospital Charge Code |
48000025
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$150.31 |
| Max. Negotiated Rate |
$375.77 |
| Rate for Payer: Aetna Commercial |
$338.19
|
| Rate for Payer: Aetna Medicare |
$187.88
|
| Rate for Payer: ASR ASR |
$364.50
|
| Rate for Payer: ASR Commercial |
$364.50
|
| Rate for Payer: BCBS Complete |
$150.31
|
| Rate for Payer: BCBS Trust/PPO |
$307.72
|
| Rate for Payer: BCN Commercial |
$291.33
|
| Rate for Payer: Cash Price |
$300.62
|
| Rate for Payer: Cofinity Commercial |
$353.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.62
|
| Rate for Payer: Healthscope Commercial |
$375.77
|
| Rate for Payer: Healthscope Whirlpool |
$364.50
|
| Rate for Payer: Mclaren Commercial |
$338.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.40
|
| Rate for Payer: Nomi Health Commercial |
$308.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.25
|
| Rate for Payer: Priority Health Narrow Network |
$263.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.68
|
|
|
HC LINE DELIVERY EXTRA
|
Facility
|
IP
|
$126.23
|
|
| Hospital Charge Code |
27000660
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.05 |
| Max. Negotiated Rate |
$126.23 |
| Rate for Payer: Aetna Commercial |
$113.61
|
| Rate for Payer: ASR ASR |
$122.44
|
| Rate for Payer: ASR Commercial |
$122.44
|
| Rate for Payer: BCBS Trust/PPO |
$102.86
|
| Rate for Payer: BCN Commercial |
$97.87
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Cofinity Commercial |
$118.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.98
|
| Rate for Payer: Healthscope Commercial |
$126.23
|
| Rate for Payer: Healthscope Whirlpool |
$122.44
|
| Rate for Payer: Mclaren Commercial |
$113.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.30
|
| Rate for Payer: Nomi Health Commercial |
$103.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.08
|
|
|
HC LINE DELIVERY EXTRA
|
Facility
|
OP
|
$126.23
|
|
| Hospital Charge Code |
27000660
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.49 |
| Max. Negotiated Rate |
$126.23 |
| Rate for Payer: Aetna Commercial |
$113.61
|
| Rate for Payer: Aetna Medicare |
$63.12
|
| Rate for Payer: ASR ASR |
$122.44
|
| Rate for Payer: ASR Commercial |
$122.44
|
| Rate for Payer: BCBS Complete |
$50.49
|
| Rate for Payer: BCBS Trust/PPO |
$103.37
|
| Rate for Payer: BCN Commercial |
$97.87
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Cofinity Commercial |
$118.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.98
|
| Rate for Payer: Healthscope Commercial |
$126.23
|
| Rate for Payer: Healthscope Whirlpool |
$122.44
|
| Rate for Payer: Mclaren Commercial |
$113.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.30
|
| Rate for Payer: Nomi Health Commercial |
$103.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.08
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
OP
|
$91.80
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$45.90
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$75.18
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.44
|
| Rate for Payer: Priority Health Narrow Network |
$64.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
IP
|
$91.80
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$74.81
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC LINE VACUUM
|
Facility
|
OP
|
$13.77
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$12.39
|
| Rate for Payer: Aetna Medicare |
$6.88
|
| Rate for Payer: ASR ASR |
$13.36
|
| Rate for Payer: ASR Commercial |
$13.36
|
| Rate for Payer: BCBS Complete |
$5.51
|
| Rate for Payer: BCBS Trust/PPO |
$11.28
|
| Rate for Payer: BCN Commercial |
$10.68
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Healthscope Whirlpool |
$13.36
|
| Rate for Payer: Mclaren Commercial |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow Network |
$9.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.12
|
|
|
HC LINE VACUUM
|
Facility
|
IP
|
$13.77
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$12.39
|
| Rate for Payer: ASR ASR |
$13.36
|
| Rate for Payer: ASR Commercial |
$13.36
|
| Rate for Payer: BCBS Trust/PPO |
$11.22
|
| Rate for Payer: BCN Commercial |
$10.68
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Healthscope Whirlpool |
$13.36
|
| Rate for Payer: Mclaren Commercial |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.12
|
|
|
HC LIPASE
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.43
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC LIPASE
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$65.32 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$6.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Complete |
$3.88
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$25.56
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.89
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$3.69
|
| Rate for Payer: Mclaren Medicare |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Meridian Medicaid |
$3.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Commercial |
$7.58
|
| Rate for Payer: PHP Medicaid |
$3.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.32
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$52.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.89
|
| Rate for Payer: UHC Exchange |
$10.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.89
|
| Rate for Payer: UHCCP DNSP |
$6.89
|
| Rate for Payer: UHCCP Medicaid |
$3.69
|
| Rate for Payer: VA VA |
$6.89
|
|
|
HC LIPASE BF
|
Facility
|
IP
|
$57.30
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.24 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$51.57
|
| Rate for Payer: ASR ASR |
$55.58
|
| Rate for Payer: ASR Commercial |
$55.58
|
| Rate for Payer: BCBS Trust/PPO |
$46.69
|
| Rate for Payer: BCN Commercial |
$44.42
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$53.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Healthscope Whirlpool |
$55.58
|
| Rate for Payer: Mclaren Commercial |
$51.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.42
|
|
|
HC LIPASE BF
|
Facility
|
OP
|
$57.30
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$65.32 |
| Rate for Payer: Aetna Commercial |
$51.57
|
| Rate for Payer: Aetna Medicare |
$6.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: ASR ASR |
$55.58
|
| Rate for Payer: ASR Commercial |
$55.58
|
| Rate for Payer: BCBS Complete |
$3.88
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$46.92
|
| Rate for Payer: BCN Commercial |
$44.42
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$53.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Healthscope Whirlpool |
$55.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.89
|
| Rate for Payer: Mclaren Commercial |
$51.57
|
| Rate for Payer: Mclaren Medicaid |
$3.69
|
| Rate for Payer: Mclaren Medicare |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Meridian Medicaid |
$3.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Commercial |
$7.58
|
| Rate for Payer: PHP Medicaid |
$3.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.32
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$52.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.89
|
| Rate for Payer: UHC Exchange |
$10.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.89
|
| Rate for Payer: UHCCP DNSP |
$6.89
|
| Rate for Payer: UHCCP Medicaid |
$3.69
|
| Rate for Payer: VA VA |
$6.89
|
|
|
HC LIPID PANEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC LIPID PANEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$105.41 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$13.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.74
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.39
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$7.18
|
| Rate for Payer: Mclaren Medicare |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$7.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$12.72
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$14.73
|
| Rate for Payer: PHP Medicaid |
$7.18
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.41
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow Network |
$84.33
|
| Rate for Payer: Railroad Medicare Medicare |
$13.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.39
|
| Rate for Payer: UHC Exchange |
$20.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.39
|
| Rate for Payer: UHCCP DNSP |
$13.39
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: VA VA |
$13.39
|
|
