|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Aetna Commercial |
$56.54
|
| Rate for Payer: ASR ASR |
$60.94
|
| Rate for Payer: BCBS Trust/PPO |
$51.59
|
| Rate for Payer: BCN Commercial |
$51.59
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$59.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$60.94
|
| Rate for Payer: Healthscope Whirlpool |
$62.82
|
| Rate for Payer: Mclaren Commercial |
$56.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.28
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Aetna Commercial |
$56.54
|
| 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 |
$60.94
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$51.80
|
| Rate for Payer: BCN Commercial |
$51.80
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$59.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$60.94
|
| Rate for Payer: Healthscope Whirlpool |
$62.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$56.54
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| 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 |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.04
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$44.04
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$517.08
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$517.08 |
| Rate for Payer: Aetna Commercial |
$465.37
|
| Rate for Payer: Aetna Medicare |
$65.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.67
|
| Rate for Payer: ASR ASR |
$501.57
|
| Rate for Payer: BCBS Complete |
$35.88
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCBS Trust/PPO |
$426.33
|
| Rate for Payer: BCN Commercial |
$426.33
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$413.66
|
| Rate for Payer: Cash Price |
$413.66
|
| Rate for Payer: Cofinity Commercial |
$486.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$501.57
|
| Rate for Payer: Healthscope Whirlpool |
$517.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$65.34
|
| Rate for Payer: Mclaren Commercial |
$465.37
|
| Rate for Payer: Mclaren Medicaid |
$65.34
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: Meridian Medicaid |
$35.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.52
|
| Rate for Payer: Nomi Health Commercial |
$424.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.81
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$71.87
|
| Rate for Payer: PHP Medicaid |
$35.02
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.46
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$70.77
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.34
|
| Rate for Payer: UHC Exchange |
$101.28
|
| Rate for Payer: UHC Medicaid |
$34.17
|
| Rate for Payer: UHCCP DNSP |
$65.34
|
| Rate for Payer: UHCCP Medicaid |
$34.17
|
| Rate for Payer: VA VA |
$65.34
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$517.08
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$387.81 |
| Max. Negotiated Rate |
$517.08 |
| Rate for Payer: Aetna Commercial |
$465.37
|
| Rate for Payer: ASR ASR |
$501.57
|
| Rate for Payer: BCBS Trust/PPO |
$424.63
|
| Rate for Payer: BCN Commercial |
$424.63
|
| Rate for Payer: Cash Price |
$413.66
|
| Rate for Payer: Cofinity Commercial |
$486.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.66
|
| Rate for Payer: Healthscope Commercial |
$501.57
|
| Rate for Payer: Healthscope Whirlpool |
$517.08
|
| Rate for Payer: Mclaren Commercial |
$465.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.52
|
| Rate for Payer: Nomi Health Commercial |
$424.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.03
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$292.61 |
| Max. Negotiated Rate |
$390.15 |
| Rate for Payer: Aetna Commercial |
$351.13
|
| Rate for Payer: ASR ASR |
$378.45
|
| Rate for Payer: BCBS Trust/PPO |
$320.39
|
| Rate for Payer: BCN Commercial |
$320.39
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$366.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$378.45
|
| Rate for Payer: Healthscope Whirlpool |
$390.15
|
| Rate for Payer: Mclaren Commercial |
$351.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.33
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$390.15 |
| Rate for Payer: Aetna Commercial |
$351.13
|
| Rate for Payer: Aetna Medicare |
$65.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.67
|
| Rate for Payer: ASR ASR |
$378.45
|
| Rate for Payer: BCBS Complete |
$35.88
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCBS Trust/PPO |
$321.68
|
| Rate for Payer: BCN Commercial |
$321.68
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$366.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$378.45
|
| Rate for Payer: Healthscope Whirlpool |
$390.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$65.34
|
| Rate for Payer: Mclaren Commercial |
$351.13
|
| Rate for Payer: Mclaren Medicaid |
$65.34
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: Meridian Medicaid |
$35.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$71.87
|
| Rate for Payer: PHP Medicaid |
$35.02
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.46
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$70.77
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.34
|
| Rate for Payer: UHC Exchange |
$101.28
|
| Rate for Payer: UHC Medicaid |
$34.17
|
| Rate for Payer: UHCCP DNSP |
$65.34
|
| Rate for Payer: UHCCP Medicaid |
$34.17
|
| Rate for Payer: VA VA |
$65.34
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$201.84
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$201.84 |
| Rate for Payer: Aetna Commercial |
$181.66
|
| Rate for Payer: Aetna Medicare |
$41.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: ASR ASR |
$195.78
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$166.42
|
| Rate for Payer: BCN Commercial |
$166.42
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$161.47
|
| Rate for Payer: Cash Price |
$161.47
|
| Rate for Payer: Cofinity Commercial |
$189.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$195.78
|
| Rate for Payer: Healthscope Whirlpool |
$201.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$41.68
|
| Rate for Payer: Mclaren Commercial |
$181.66
|
| Rate for Payer: Mclaren Medicaid |
$41.68
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: Meridian Medicaid |
$22.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.56
|
| Rate for Payer: Nomi Health Commercial |
$165.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.38
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$45.85
|
| Rate for Payer: PHP Medicaid |
$22.34
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$176.85
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$141.49
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.68
|
| Rate for Payer: UHC Exchange |
$64.60
|
| Rate for Payer: UHC Medicaid |
$21.80
|
| Rate for Payer: UHCCP DNSP |
$41.68
|
| Rate for Payer: UHCCP Medicaid |
$21.80
|
| Rate for Payer: VA VA |
$41.68
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$201.84
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$151.38 |
| Max. Negotiated Rate |
$201.84 |
| Rate for Payer: Aetna Commercial |
$181.66
|
| Rate for Payer: ASR ASR |
$195.78
|
| Rate for Payer: BCBS Trust/PPO |
$165.75
|
| Rate for Payer: BCN Commercial |
$165.75
|
| Rate for Payer: Cash Price |
$161.47
|
| Rate for Payer: Cofinity Commercial |
$189.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.47
|
| Rate for Payer: Healthscope Commercial |
$195.78
|
| Rate for Payer: Healthscope Whirlpool |
$201.84
|
| Rate for Payer: Mclaren Commercial |
$181.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.56
|
| Rate for Payer: Nomi Health Commercial |
$165.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.62
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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 MUCORE RACEMOSUS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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 MUGWORT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
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 MUGWORT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
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 MULBERRY IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
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 MULBERRY IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
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 MULTIDNA LYME/UREAPLASMA
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600354
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.71 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$117.00
|
| Rate for Payer: Aetna Medicare |
$70.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.75
|
| Rate for Payer: ASR ASR |
$126.10
|
| Rate for Payer: BCBS Complete |
$38.55
|
| Rate for Payer: BCBS MAPPO |
$70.20
|
| Rate for Payer: BCBS Trust/PPO |
$107.19
|
| Rate for Payer: BCN Commercial |
$107.19
|
| Rate for Payer: BCN Medicare Advantage |
$70.20
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$122.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.20
|
| Rate for Payer: Healthscope Commercial |
$126.10
|
| Rate for Payer: Healthscope Whirlpool |
$130.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.20
|
| Rate for Payer: Mclaren Commercial |
$117.00
|
| Rate for Payer: Mclaren Medicaid |
$70.20
|
| Rate for Payer: Mclaren Medicare |
$70.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.71
|
| Rate for Payer: Meridian Medicaid |
$38.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.50
|
| Rate for Payer: Nomi Health Commercial |
$106.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE Medicare |
$66.69
|
| Rate for Payer: PACE SWMI |
$70.20
|
| Rate for Payer: PHP Commercial |
$77.22
|
| Rate for Payer: PHP Medicaid |
$37.63
|
| Rate for Payer: PHP Medicare Advantage |
$70.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.91
|
| Rate for Payer: Priority Health Medicare |
$70.20
|
| Rate for Payer: Priority Health Narrow Network |
$91.13
|
| Rate for Payer: Railroad Medicare Medicare |
$70.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.20
|
| Rate for Payer: UHC Exchange |
$108.81
|
| Rate for Payer: UHC Medicaid |
$36.71
|
| Rate for Payer: UHCCP DNSP |
$70.20
|
| Rate for Payer: UHCCP Medicaid |
$36.71
|
| Rate for Payer: VA VA |
$70.20
|
|
|
HC MULTIDNA LYME/UREAPLASMA
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600354
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$117.00
|
| Rate for Payer: ASR ASR |
$126.10
|
| Rate for Payer: BCBS Trust/PPO |
$106.76
|
| Rate for Payer: BCN Commercial |
$106.76
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$122.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.00
|
| Rate for Payer: Healthscope Commercial |
$126.10
|
| Rate for Payer: Healthscope Whirlpool |
$130.00
|
| Rate for Payer: Mclaren Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.50
|
| Rate for Payer: Nomi Health Commercial |
$106.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.40
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$6.81
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$6.81 |
| Rate for Payer: Aetna Commercial |
$6.13
|
| Rate for Payer: ASR ASR |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$5.59
|
| Rate for Payer: BCN Commercial |
$5.59
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: Cofinity Commercial |
$6.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.45
|
| Rate for Payer: Healthscope Commercial |
$6.61
|
| Rate for Payer: Healthscope Whirlpool |
$6.81
|
| Rate for Payer: Mclaren Commercial |
$6.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.79
|
| Rate for Payer: Nomi Health Commercial |
$5.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.99
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
OP
|
$6.81
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$6.81 |
| Rate for Payer: Aetna Commercial |
$6.13
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: ASR ASR |
$6.61
|
| Rate for Payer: BCBS Complete |
$2.72
|
| Rate for Payer: BCBS Trust/PPO |
$5.61
|
| Rate for Payer: BCN Commercial |
$5.61
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: Cash Price |
$5.45
|
| Rate for Payer: Cofinity Commercial |
$6.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.45
|
| Rate for Payer: Healthscope Commercial |
$6.61
|
| Rate for Payer: Healthscope Whirlpool |
$6.81
|
| Rate for Payer: Mclaren Commercial |
$6.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.79
|
| Rate for Payer: Nomi Health Commercial |
$5.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.87
|
| Rate for Payer: Priority Health Narrow Network |
$1.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.99
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$654.41
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Aetna Commercial |
$588.97
|
| Rate for Payer: Aetna Medicare |
$161.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: ASR ASR |
$634.78
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$539.56
|
| Rate for Payer: BCN Commercial |
$539.56
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$523.53
|
| Rate for Payer: Cash Price |
$523.53
|
| Rate for Payer: Cofinity Commercial |
$615.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$523.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$634.78
|
| Rate for Payer: Healthscope Whirlpool |
$654.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$161.92
|
| Rate for Payer: Mclaren Commercial |
$588.97
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$88.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.25
|
| Rate for Payer: Nomi Health Commercial |
$536.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.81
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$178.11
|
| Rate for Payer: PHP Medicaid |
$86.79
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$573.39
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health Narrow Network |
$458.74
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$575.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$250.98
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP DNSP |
$161.92
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$654.41
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$490.81 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Aetna Commercial |
$588.97
|
| Rate for Payer: ASR ASR |
$634.78
|
| Rate for Payer: BCBS Trust/PPO |
$537.40
|
| Rate for Payer: BCN Commercial |
$537.40
|
| Rate for Payer: Cash Price |
$523.53
|
| Rate for Payer: Cofinity Commercial |
$615.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$523.53
|
| Rate for Payer: Healthscope Commercial |
$634.78
|
| Rate for Payer: Healthscope Whirlpool |
$654.41
|
| Rate for Payer: Mclaren Commercial |
$588.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.25
|
| Rate for Payer: Nomi Health Commercial |
$536.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$575.88
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
OP
|
$870.19
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$195.12 |
| Max. Negotiated Rate |
$870.19 |
| Rate for Payer: Aetna Commercial |
$783.17
|
| Rate for Payer: Aetna Medicare |
$373.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: ASR ASR |
$844.08
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$717.47
|
| Rate for Payer: BCN Commercial |
$717.47
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cofinity Commercial |
$817.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$844.08
|
| Rate for Payer: Healthscope Whirlpool |
$870.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$373.08
|
| Rate for Payer: Mclaren Commercial |
$783.17
|
| Rate for Payer: Mclaren Medicaid |
$373.08
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$204.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.66
|
| Rate for Payer: Nomi Health Commercial |
$713.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$652.64
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$410.39
|
| Rate for Payer: PHP Medicaid |
$199.97
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$762.46
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health Narrow Network |
$610.00
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$578.27
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP DNSP |
$373.08
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: VA VA |
$373.08
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
IP
|
$870.19
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$652.64 |
| Max. Negotiated Rate |
$870.19 |
| Rate for Payer: Aetna Commercial |
$783.17
|
| Rate for Payer: ASR ASR |
$844.08
|
| Rate for Payer: BCBS Trust/PPO |
$714.60
|
| Rate for Payer: BCN Commercial |
$714.60
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cofinity Commercial |
$817.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.15
|
| Rate for Payer: Healthscope Commercial |
$844.08
|
| Rate for Payer: Healthscope Whirlpool |
$870.19
|
| Rate for Payer: Mclaren Commercial |
$783.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.66
|
| Rate for Payer: Nomi Health Commercial |
$713.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$652.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.77
|
|
|
HC MULTIPLE SCLEROSIS CASCADE, S AND CSF
|
Facility
|
OP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100769
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Aetna Commercial |
$108.07
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$116.48
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$99.01
|
| Rate for Payer: BCN Commercial |
$99.01
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$112.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$116.48
|
| Rate for Payer: Healthscope Whirlpool |
$120.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$108.07
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.07
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.06
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$105.21
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$84.18
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC MULTIPLE SCLEROSIS CASCADE, S AND CSF
|
Facility
|
IP
|
$120.08
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100769
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$90.06 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Aetna Commercial |
$108.07
|
| Rate for Payer: ASR ASR |
$116.48
|
| Rate for Payer: BCBS Trust/PPO |
$98.61
|
| Rate for Payer: BCN Commercial |
$98.61
|
| Rate for Payer: Cash Price |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$112.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.06
|
| Rate for Payer: Healthscope Commercial |
$116.48
|
| Rate for Payer: Healthscope Whirlpool |
$120.08
|
| Rate for Payer: Mclaren Commercial |
$108.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.07
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.67
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
IP
|
$124.93
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.70 |
| Max. Negotiated Rate |
$124.93 |
| Rate for Payer: Aetna Commercial |
$112.44
|
| Rate for Payer: ASR ASR |
$121.18
|
| Rate for Payer: BCBS Trust/PPO |
$102.59
|
| Rate for Payer: BCN Commercial |
$102.59
|
| Rate for Payer: Cash Price |
$99.94
|
| Rate for Payer: Cofinity Commercial |
$117.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.94
|
| Rate for Payer: Healthscope Commercial |
$121.18
|
| Rate for Payer: Healthscope Whirlpool |
$124.93
|
| Rate for Payer: Mclaren Commercial |
$112.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.19
|
| Rate for Payer: Nomi Health Commercial |
$102.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.94
|
|
