|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
OP
|
$83.47
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$83.47 |
| Rate for Payer: Aetna Commercial |
$75.12
|
| 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 |
$80.97
|
| Rate for Payer: ASR Commercial |
$80.97
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$68.35
|
| Rate for Payer: BCN Commercial |
$64.71
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$78.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$83.47
|
| Rate for Payer: Healthscope Whirlpool |
$80.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$75.12
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.95
|
| Rate for Payer: Nomi Health Commercial |
$68.45
|
| 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 |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.14
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$58.51
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
IP
|
$83.47
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.26 |
| Max. Negotiated Rate |
$83.47 |
| Rate for Payer: Aetna Commercial |
$75.12
|
| Rate for Payer: ASR ASR |
$80.97
|
| Rate for Payer: ASR Commercial |
$80.97
|
| Rate for Payer: BCBS Trust/PPO |
$68.02
|
| Rate for Payer: BCN Commercial |
$64.71
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$78.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.78
|
| Rate for Payer: Healthscope Commercial |
$83.47
|
| Rate for Payer: Healthscope Whirlpool |
$80.97
|
| Rate for Payer: Mclaren Commercial |
$75.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.95
|
| Rate for Payer: Nomi Health Commercial |
$68.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.45
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
OP
|
$81.15
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$81.15 |
| Rate for Payer: Aetna Commercial |
$73.03
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$78.72
|
| Rate for Payer: ASR Commercial |
$78.72
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$66.45
|
| Rate for Payer: BCN Commercial |
$62.92
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$76.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$81.15
|
| Rate for Payer: Healthscope Whirlpool |
$78.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$73.03
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.10
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$56.89
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
IP
|
$81.15
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.75 |
| Max. Negotiated Rate |
$81.15 |
| Rate for Payer: Aetna Commercial |
$73.03
|
| Rate for Payer: ASR ASR |
$78.72
|
| Rate for Payer: ASR Commercial |
$78.72
|
| Rate for Payer: BCBS Trust/PPO |
$66.13
|
| Rate for Payer: BCN Commercial |
$62.92
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$76.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Healthscope Commercial |
$81.15
|
| Rate for Payer: Healthscope Whirlpool |
$78.72
|
| Rate for Payer: Mclaren Commercial |
$73.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.41
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$229.50
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$247.35
|
| Rate for Payer: ASR Commercial |
$247.35
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$208.82
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$255.00
|
| Rate for Payer: Healthscope Whirlpool |
$247.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.43
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$178.75
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$229.50
|
| Rate for Payer: ASR ASR |
$247.35
|
| Rate for Payer: ASR Commercial |
$247.35
|
| Rate for Payer: BCBS Trust/PPO |
$207.80
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$255.00
|
| Rate for Payer: Healthscope Whirlpool |
$247.35
|
| Rate for Payer: Mclaren Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.40
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| 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 |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| 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 MGLUR1 AB IFA TITER, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| 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 |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| 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 M. GRAVIS EVAL, ADULT
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: ASR Commercial |
$69.64
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$58.79
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$71.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.90
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$50.32
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: ASR Commercial |
$69.64
|
| Rate for Payer: BCBS Trust/PPO |
$58.50
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$71.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.64
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: ASR Commercial |
$69.64
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$58.79
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$71.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.90
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$50.32
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: ASR Commercial |
$69.64
|
| Rate for Payer: BCBS Trust/PPO |
$58.50
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$71.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.64
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| 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 |
$69.64
|
| Rate for Payer: ASR Commercial |
$69.64
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$58.79
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$71.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| 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 |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.90
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$50.32
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: ASR Commercial |
$69.64
|
| Rate for Payer: BCBS Trust/PPO |
$58.50
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$71.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.64
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.31
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$8.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.81
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: ASR Commercial |
$44.41
|
| Rate for Payer: BCBS Complete |
$4.87
|
| Rate for Payer: BCBS MAPPO |
$8.65
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: BCN Medicare Advantage |
$8.65
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.65
|
| Rate for Payer: Healthscope Commercial |
$45.78
|
| Rate for Payer: Healthscope Whirlpool |
$44.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.65
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$4.64
|
| Rate for Payer: Mclaren Medicare |
$8.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.08
|
| Rate for Payer: Meridian Medicaid |
$4.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Medicare |
$8.22
|
| Rate for Payer: PACE SWMI |
$8.65
|
| Rate for Payer: PHP Commercial |
$9.52
|
| Rate for Payer: PHP Medicaid |
$4.64
|
| Rate for Payer: PHP Medicare Advantage |
$8.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Medicare |
$8.65
|
| Rate for Payer: Priority Health Narrow Network |
$32.09
|
| Rate for Payer: Railroad Medicare Medicare |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.65
|
| Rate for Payer: UHC Exchange |
$13.41
|
| Rate for Payer: UHC Medicare Advantage |
$8.65
|
| Rate for Payer: UHCCP DNSP |
$8.65
|
| Rate for Payer: UHCCP Medicaid |
$4.64
|
| Rate for Payer: VA VA |
$8.65
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,231.63
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,892.65 |
| Max. Negotiated Rate |
$17,231.63 |
| Rate for Payer: Aetna Commercial |
$15,508.47
|
| Rate for Payer: Aetna Medicare |
$8,615.82
|
| Rate for Payer: ASR ASR |
$16,714.68
|
| Rate for Payer: ASR Commercial |
$16,714.68
|
| Rate for Payer: BCBS Complete |
$6,892.65
|
| Rate for Payer: BCBS Trust/PPO |
$14,110.98
|
| Rate for Payer: BCN Commercial |
$13,359.68
|
| Rate for Payer: Cash Price |
$13,785.30
|
| Rate for Payer: Cofinity Commercial |
$16,197.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,785.30
|
| Rate for Payer: Healthscope Commercial |
$17,231.63
|
| Rate for Payer: Healthscope Whirlpool |
$16,714.68
|
| Rate for Payer: Mclaren Commercial |
$15,508.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,646.89
|
| Rate for Payer: Nomi Health Commercial |
$14,129.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,200.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,098.35
|
| Rate for Payer: Priority Health Narrow Network |
$12,079.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,163.83
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,231.63
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,200.56 |
| Max. Negotiated Rate |
$17,231.63 |
| Rate for Payer: Aetna Commercial |
$15,508.47
|
| Rate for Payer: ASR ASR |
$16,714.68
|
| Rate for Payer: ASR Commercial |
$16,714.68
|
| Rate for Payer: BCBS Trust/PPO |
$14,042.06
|
| Rate for Payer: BCN Commercial |
$13,359.68
|
| Rate for Payer: Cash Price |
$13,785.30
|
| Rate for Payer: Cofinity Commercial |
$16,197.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,785.30
|
| Rate for Payer: Healthscope Commercial |
$17,231.63
|
| Rate for Payer: Healthscope Whirlpool |
$16,714.68
|
| Rate for Payer: Mclaren Commercial |
$15,508.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,646.89
|
| Rate for Payer: Nomi Health Commercial |
$14,129.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,200.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,163.83
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,615.28
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,449.93 |
| Max. Negotiated Rate |
$17,615.28 |
| Rate for Payer: Aetna Commercial |
$15,853.75
|
| Rate for Payer: ASR ASR |
$17,086.82
|
| Rate for Payer: ASR Commercial |
$17,086.82
|
| Rate for Payer: BCBS Trust/PPO |
$14,354.69
|
| Rate for Payer: BCN Commercial |
$13,657.13
|
| Rate for Payer: Cash Price |
$14,092.22
|
| Rate for Payer: Cofinity Commercial |
$16,558.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,092.22
|
| Rate for Payer: Healthscope Commercial |
$17,615.28
|
| Rate for Payer: Healthscope Whirlpool |
$17,086.82
|
| Rate for Payer: Mclaren Commercial |
$15,853.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,972.99
|
| Rate for Payer: Nomi Health Commercial |
$14,444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,449.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,501.45
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,615.28
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,046.11 |
| Max. Negotiated Rate |
$17,615.28 |
| Rate for Payer: Aetna Commercial |
$15,853.75
|
| Rate for Payer: Aetna Medicare |
$8,807.64
|
| Rate for Payer: ASR ASR |
$17,086.82
|
| Rate for Payer: ASR Commercial |
$17,086.82
|
| Rate for Payer: BCBS Complete |
$7,046.11
|
| Rate for Payer: BCBS Trust/PPO |
$14,425.15
|
| Rate for Payer: BCN Commercial |
$13,657.13
|
| Rate for Payer: Cash Price |
$14,092.22
|
| Rate for Payer: Cofinity Commercial |
$16,558.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,092.22
|
| Rate for Payer: Healthscope Commercial |
$17,615.28
|
| Rate for Payer: Healthscope Whirlpool |
$17,086.82
|
| Rate for Payer: Mclaren Commercial |
$15,853.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,972.99
|
| Rate for Payer: Nomi Health Commercial |
$14,444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,449.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,434.51
|
| Rate for Payer: Priority Health Narrow Network |
$12,348.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,501.45
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare |
$5.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.22
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS MAPPO |
$5.78
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: BCN Medicare Advantage |
$5.78
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.78
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.78
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Mclaren Medicare |
$5.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.07
|
| Rate for Payer: Meridian Medicaid |
$3.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Medicare |
$5.49
|
| Rate for Payer: PACE SWMI |
$5.78
|
| Rate for Payer: PHP Commercial |
$6.36
|
| Rate for Payer: PHP Medicaid |
$3.10
|
| Rate for Payer: PHP Medicare Advantage |
$5.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.39
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow Network |
$53.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.78
|
| Rate for Payer: UHC Exchange |
$8.96
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: UHCCP DNSP |
$5.78
|
| Rate for Payer: UHCCP Medicaid |
$3.10
|
| Rate for Payer: VA VA |
$5.78
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.67
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$22.89 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: Aetna Medicare |
$6.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$18.74
|
| Rate for Payer: BCN Commercial |
$17.75
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.68
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$7.35
|
| Rate for Payer: PHP Medicaid |
$3.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.06
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$16.05
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.68
|
| Rate for Payer: UHC Exchange |
$10.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.68
|
| Rate for Payer: UHCCP DNSP |
$6.68
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: VA VA |
$6.68
|
|
