|
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
|
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 |
$39.54
|
| Rate for Payer: Priority Health Medicare |
$8.65
|
| Rate for Payer: Priority Health Narrow Network |
$31.63
|
| 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 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 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 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 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 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 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 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 |
$53.80
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow Network |
$43.04
|
| 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 MICROSPORIDIA DETECTION
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$22.89 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCN Commercial |
$17.75
|
| 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: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
|
|
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 |
$20.87
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$16.70
|
| 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
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$125.17 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.49
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: ASR Commercial |
$31.66
|
| Rate for Payer: BCBS Complete |
$3.37
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Healthscope Whirlpool |
$31.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.99
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Mclaren Medicaid |
$3.21
|
| Rate for Payer: Mclaren Medicare |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.29
|
| Rate for Payer: Meridian Medicaid |
$3.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: PACE Medicare |
$5.69
|
| Rate for Payer: PACE SWMI |
$5.99
|
| Rate for Payer: PHP Commercial |
$6.59
|
| Rate for Payer: PHP Medicaid |
$3.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.17
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow Network |
$100.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.99
|
| Rate for Payer: UHC Exchange |
$9.28
|
| Rate for Payer: UHC Medicare Advantage |
$5.99
|
| Rate for Payer: UHCCP DNSP |
$5.99
|
| Rate for Payer: UHCCP Medicaid |
$3.21
|
| Rate for Payer: VA VA |
$5.99
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$32.64 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: ASR Commercial |
$31.66
|
| Rate for Payer: BCBS Trust/PPO |
$26.60
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Healthscope Whirlpool |
$31.66
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$375.36 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| 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 |
$364.10
|
| Rate for Payer: ASR Commercial |
$364.10
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$307.38
|
| Rate for Payer: BCN Commercial |
$291.02
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$352.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$375.36
|
| Rate for Payer: Healthscope Whirlpool |
$364.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$337.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.89
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$263.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$243.98 |
| Max. Negotiated Rate |
$375.36 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: ASR ASR |
$364.10
|
| Rate for Payer: ASR Commercial |
$364.10
|
| Rate for Payer: BCBS Trust/PPO |
$305.88
|
| Rate for Payer: BCN Commercial |
$291.02
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$352.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$375.36
|
| Rate for Payer: Healthscope Whirlpool |
$364.10
|
| Rate for Payer: Mclaren Commercial |
$337.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.32
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$200.94 |
| Rate for Payer: Aetna Commercial |
$180.85
|
| Rate for Payer: Aetna Medicare |
$100.47
|
| Rate for Payer: ASR ASR |
$194.91
|
| Rate for Payer: ASR Commercial |
$194.91
|
| Rate for Payer: BCBS Complete |
$80.38
|
| Rate for Payer: BCBS Trust/PPO |
$164.55
|
| Rate for Payer: BCN Commercial |
$155.79
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$188.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$200.94
|
| Rate for Payer: Healthscope Whirlpool |
$194.91
|
| Rate for Payer: Mclaren Commercial |
$180.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: Nomi Health Commercial |
$164.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.83
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$130.61 |
| Max. Negotiated Rate |
$200.94 |
| Rate for Payer: Aetna Commercial |
$180.85
|
| Rate for Payer: ASR ASR |
$194.91
|
| Rate for Payer: ASR Commercial |
$194.91
|
| Rate for Payer: BCBS Trust/PPO |
$163.75
|
| Rate for Payer: BCN Commercial |
$155.79
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$188.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$200.94
|
| Rate for Payer: Healthscope Whirlpool |
$194.91
|
| Rate for Payer: Mclaren Commercial |
$180.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: Nomi Health Commercial |
$164.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.83
|
|
|
HC MILK IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MILK IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
OP
|
$309.26
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$309.26 |
| Rate for Payer: Aetna Commercial |
$278.33
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$299.98
|
| Rate for Payer: ASR Commercial |
$299.98
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$253.25
|
| Rate for Payer: BCN Commercial |
$239.77
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cofinity Commercial |
$290.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$309.26
|
| Rate for Payer: Healthscope Whirlpool |
$299.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$278.33
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.87
|
| Rate for Payer: Nomi Health Commercial |
$253.59
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.94
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$71.15
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$309.26
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$201.02 |
| Max. Negotiated Rate |
$309.26 |
| Rate for Payer: Aetna Commercial |
$278.33
|
| Rate for Payer: ASR ASR |
$299.98
|
| Rate for Payer: ASR Commercial |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$252.02
|
| Rate for Payer: BCN Commercial |
$239.77
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cofinity Commercial |
$290.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.41
|
| Rate for Payer: Healthscope Commercial |
$309.26
|
| Rate for Payer: Healthscope Whirlpool |
$299.98
|
| Rate for Payer: Mclaren Commercial |
$278.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.87
|
| Rate for Payer: Nomi Health Commercial |
$253.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.15
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$6.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$3.74
|
| Rate for Payer: BCBS MAPPO |
$6.64
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.64
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.64
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.64
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Mclaren Medicare |
$6.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.97
|
| Rate for Payer: Meridian Medicaid |
$3.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Medicare |
$6.31
|
| Rate for Payer: PACE SWMI |
$6.64
|
| Rate for Payer: PHP Commercial |
$7.30
|
| Rate for Payer: PHP Medicaid |
$3.56
|
| Rate for Payer: PHP Medicare Advantage |
$6.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.81
|
| Rate for Payer: Priority Health Medicare |
$6.64
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: Railroad Medicare Medicare |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.64
|
| Rate for Payer: UHC Exchange |
$10.29
|
| Rate for Payer: UHC Medicare Advantage |
$6.64
|
| Rate for Payer: UHCCP DNSP |
$6.64
|
| Rate for Payer: UHCCP Medicaid |
$3.56
|
| Rate for Payer: VA VA |
$6.64
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.53 |
| Max. Negotiated Rate |
$62.26 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$40.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.21
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Complete |
$22.61
|
| Rate for Payer: BCBS MAPPO |
$40.17
|
| Rate for Payer: BCBS Trust/PPO |
$38.34
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$40.17
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.17
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$40.17
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$21.53
|
| Rate for Payer: Mclaren Medicare |
$40.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.18
|
| Rate for Payer: Meridian Medicaid |
$22.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Medicare |
$38.16
|
| Rate for Payer: PACE SWMI |
$40.17
|
| Rate for Payer: PHP Commercial |
$44.19
|
| Rate for Payer: PHP Medicaid |
$21.53
|
| Rate for Payer: PHP Medicare Advantage |
$40.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.02
|
| Rate for Payer: Priority Health Medicare |
$40.17
|
| Rate for Payer: Priority Health Narrow Network |
$32.82
|
| Rate for Payer: Railroad Medicare Medicare |
$40.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.17
|
| Rate for Payer: UHC Exchange |
$62.26
|
| Rate for Payer: UHC Medicare Advantage |
$40.17
|
| Rate for Payer: UHCCP DNSP |
$40.17
|
| Rate for Payer: UHCCP Medicaid |
$21.53
|
| Rate for Payer: VA VA |
$40.17
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.15
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
