|
HC MONITOR SET QUICK PRESSURE
|
Facility
|
OP
|
$437.50
|
|
| Hospital Charge Code |
27000707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna Commercial |
$393.75
|
| Rate for Payer: Aetna Medicare |
$218.75
|
| Rate for Payer: ASR ASR |
$424.38
|
| Rate for Payer: ASR Commercial |
$424.38
|
| Rate for Payer: BCBS Complete |
$175.00
|
| Rate for Payer: BCBS Trust/PPO |
$358.27
|
| Rate for Payer: BCN Commercial |
$339.19
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cofinity Commercial |
$411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.00
|
| Rate for Payer: Healthscope Commercial |
$437.50
|
| Rate for Payer: Healthscope Whirlpool |
$424.38
|
| Rate for Payer: Mclaren Commercial |
$393.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.88
|
| Rate for Payer: Nomi Health Commercial |
$358.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.34
|
| Rate for Payer: Priority Health Narrow Network |
$306.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.00
|
|
|
HC MONO SCREENING MONOSPOT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200186
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$39.54 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.54
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$31.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC MONO SCREENING MONOSPOT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200186
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC MORPHINE LVL
|
Facility
|
OP
|
$119.34
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna Commercial |
$107.41
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: ASR ASR |
$115.76
|
| Rate for Payer: ASR Commercial |
$115.76
|
| Rate for Payer: BCBS Complete |
$47.74
|
| Rate for Payer: BCBS Trust/PPO |
$97.73
|
| Rate for Payer: BCN Commercial |
$92.52
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$112.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Healthscope Whirlpool |
$115.76
|
| Rate for Payer: Mclaren Commercial |
$107.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.44
|
| Rate for Payer: Nomi Health Commercial |
$97.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.57
|
| Rate for Payer: Priority Health Narrow Network |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.02
|
|
|
HC MORPHINE LVL
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.57 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna Commercial |
$107.41
|
| Rate for Payer: ASR ASR |
$115.76
|
| Rate for Payer: ASR Commercial |
$115.76
|
| Rate for Payer: BCBS Trust/PPO |
$97.25
|
| Rate for Payer: BCN Commercial |
$92.52
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$112.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Healthscope Whirlpool |
$115.76
|
| Rate for Payer: Mclaren Commercial |
$107.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.44
|
| Rate for Payer: Nomi Health Commercial |
$97.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.02
|
|
|
HC MOUSE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
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 MOUSE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
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 MPCDS CELL SORTING BM
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$47.44 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Aetna Commercial |
$153.70
|
| Rate for Payer: Aetna Medicare |
$352.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: ASR ASR |
$165.66
|
| Rate for Payer: ASR Commercial |
$165.66
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$139.85
|
| Rate for Payer: BCN Commercial |
$132.41
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$160.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$170.78
|
| Rate for Payer: Healthscope Whirlpool |
$165.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$352.45
|
| Rate for Payer: Mclaren Commercial |
$153.70
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$387.70
|
| Rate for Payer: PHP Medicaid |
$188.91
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.30
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$47.44
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$546.30
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP DNSP |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: VA VA |
$352.45
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$170.78 |
| Rate for Payer: Aetna Commercial |
$153.70
|
| Rate for Payer: ASR ASR |
$165.66
|
| Rate for Payer: ASR Commercial |
$165.66
|
| Rate for Payer: BCBS Trust/PPO |
$139.17
|
| Rate for Payer: BCN Commercial |
$132.41
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$160.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$170.78
|
| Rate for Payer: Healthscope Whirlpool |
$165.66
|
| Rate for Payer: Mclaren Commercial |
$153.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.29
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
IP
|
$53.78
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$34.96 |
| Max. Negotiated Rate |
$53.78 |
| Rate for Payer: Aetna Commercial |
$48.40
|
| Rate for Payer: ASR ASR |
$52.17
|
| Rate for Payer: ASR Commercial |
$52.17
|
| Rate for Payer: BCBS Trust/PPO |
$43.83
|
| Rate for Payer: BCN Commercial |
$41.70
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cofinity Commercial |
$50.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.02
|
| Rate for Payer: Healthscope Commercial |
$53.78
|
| Rate for Payer: Healthscope Whirlpool |
$52.17
|
| Rate for Payer: Mclaren Commercial |
$48.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.71
|
| Rate for Payer: Nomi Health Commercial |
$44.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.33
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
OP
|
$53.78
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$59.30 |
| Rate for Payer: Aetna Commercial |
$48.40
|
| Rate for Payer: Aetna Medicare |
$26.89
|
| Rate for Payer: ASR ASR |
$52.17
|
| Rate for Payer: ASR Commercial |
$52.17
|
| Rate for Payer: BCBS Complete |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$44.04
|
| Rate for Payer: BCN Commercial |
$41.70
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cofinity Commercial |
$50.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.02
|
| Rate for Payer: Healthscope Commercial |
$53.78
|
| Rate for Payer: Healthscope Whirlpool |
$52.17
|
| Rate for Payer: Mclaren Commercial |
$48.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.71
|
| Rate for Payer: Nomi Health Commercial |
$44.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.30
|
| Rate for Payer: Priority Health Narrow Network |
$47.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.33
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
IP
|
$379.75
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$246.84 |
| Max. Negotiated Rate |
$379.75 |
| Rate for Payer: Aetna Commercial |
$341.78
|
| Rate for Payer: ASR ASR |
$368.36
|
| Rate for Payer: ASR Commercial |
$368.36
|
| Rate for Payer: BCBS Trust/PPO |
$309.46
|
| Rate for Payer: BCN Commercial |
$294.42
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cofinity Commercial |
$356.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.80
|
| Rate for Payer: Healthscope Commercial |
$379.75
|
| Rate for Payer: Healthscope Whirlpool |
$368.36
|
| Rate for Payer: Mclaren Commercial |
$341.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.79
|
| Rate for Payer: Nomi Health Commercial |
$311.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.18
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
OP
|
$379.75
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.27 |
| Max. Negotiated Rate |
$379.75 |
| Rate for Payer: Aetna Commercial |
$341.78
|
| Rate for Payer: Aetna Medicare |
$185.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.50
|
| Rate for Payer: ASR ASR |
$368.36
|
| Rate for Payer: ASR Commercial |
$368.36
|
| Rate for Payer: BCBS Complete |
$104.23
|
| Rate for Payer: BCBS MAPPO |
$185.20
|
| Rate for Payer: BCBS Trust/PPO |
$310.98
|
| Rate for Payer: BCN Commercial |
$294.42
|
| Rate for Payer: BCN Medicare Advantage |
$185.20
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cofinity Commercial |
$356.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.20
|
| Rate for Payer: Healthscope Commercial |
$379.75
|
| Rate for Payer: Healthscope Whirlpool |
$368.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$185.20
|
| Rate for Payer: Mclaren Commercial |
$341.78
|
| Rate for Payer: Mclaren Medicaid |
$99.27
|
| Rate for Payer: Mclaren Medicare |
$185.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.46
|
| Rate for Payer: Meridian Medicaid |
$104.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.79
|
| Rate for Payer: Nomi Health Commercial |
$311.40
|
| Rate for Payer: PACE Medicare |
$175.94
|
| Rate for Payer: PACE SWMI |
$185.20
|
| Rate for Payer: PHP Commercial |
$203.72
|
| Rate for Payer: PHP Medicaid |
$99.27
|
| Rate for Payer: PHP Medicare Advantage |
$185.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.74
|
| Rate for Payer: Priority Health Medicare |
$185.20
|
| Rate for Payer: Priority Health Narrow Network |
$266.20
|
| Rate for Payer: Railroad Medicare Medicare |
$185.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.20
|
| Rate for Payer: UHC Exchange |
$287.06
|
| Rate for Payer: UHC Medicare Advantage |
$185.20
|
| Rate for Payer: UHCCP DNSP |
$185.20
|
| Rate for Payer: UHCCP Medicaid |
$99.27
|
| Rate for Payer: VA VA |
$185.20
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
IP
|
$600.31
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$390.20 |
| Max. Negotiated Rate |
$600.31 |
| Rate for Payer: Aetna Commercial |
$540.28
|
| Rate for Payer: ASR ASR |
$582.30
|
| Rate for Payer: ASR Commercial |
$582.30
|
| Rate for Payer: BCBS Trust/PPO |
$489.19
|
| Rate for Payer: BCN Commercial |
$465.42
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cofinity Commercial |
$564.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.25
|
| Rate for Payer: Healthscope Commercial |
$600.31
|
| Rate for Payer: Healthscope Whirlpool |
$582.30
|
| Rate for Payer: Mclaren Commercial |
$540.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.26
|
| Rate for Payer: Nomi Health Commercial |
$492.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.27
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
OP
|
$600.31
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$160.80 |
| Max. Negotiated Rate |
$600.31 |
| Rate for Payer: Aetna Commercial |
$540.28
|
| Rate for Payer: Aetna Medicare |
$300.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.00
|
| Rate for Payer: ASR ASR |
$582.30
|
| Rate for Payer: ASR Commercial |
$582.30
|
| Rate for Payer: BCBS Complete |
$168.84
|
| Rate for Payer: BCBS MAPPO |
$300.00
|
| Rate for Payer: BCBS Trust/PPO |
$491.59
|
| Rate for Payer: BCN Commercial |
$465.42
|
| Rate for Payer: BCN Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cofinity Commercial |
$564.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$600.31
|
| Rate for Payer: Healthscope Whirlpool |
$582.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$300.00
|
| Rate for Payer: Mclaren Commercial |
$540.28
|
| Rate for Payer: Mclaren Medicaid |
$160.80
|
| Rate for Payer: Mclaren Medicare |
$300.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.00
|
| Rate for Payer: Meridian Medicaid |
$168.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.26
|
| Rate for Payer: Nomi Health Commercial |
$492.25
|
| Rate for Payer: PACE Medicare |
$285.00
|
| Rate for Payer: PACE SWMI |
$300.00
|
| Rate for Payer: PHP Commercial |
$330.00
|
| Rate for Payer: PHP Medicaid |
$160.80
|
| Rate for Payer: PHP Medicare Advantage |
$300.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$525.99
|
| Rate for Payer: Priority Health Medicare |
$300.00
|
| Rate for Payer: Priority Health Narrow Network |
$420.82
|
| Rate for Payer: Railroad Medicare Medicare |
$300.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.00
|
| Rate for Payer: UHC Exchange |
$465.00
|
| Rate for Payer: UHC Medicare Advantage |
$300.00
|
| Rate for Payer: UHCCP DNSP |
$300.00
|
| Rate for Payer: UHCCP Medicaid |
$160.80
|
| Rate for Payer: VA VA |
$300.00
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
IP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$648.17 |
| Rate for Payer: Aetna Commercial |
$583.35
|
| Rate for Payer: ASR ASR |
$628.72
|
| Rate for Payer: ASR Commercial |
$628.72
|
| Rate for Payer: BCBS Trust/PPO |
$528.19
|
| Rate for Payer: BCN Commercial |
$502.53
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$609.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Healthscope Commercial |
$648.17
|
| Rate for Payer: Healthscope Whirlpool |
$628.72
|
| Rate for Payer: Mclaren Commercial |
$583.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: Nomi Health Commercial |
$531.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.39
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
OP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$648.17 |
| Rate for Payer: Aetna Commercial |
$583.35
|
| Rate for Payer: Aetna Medicare |
$121.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: ASR ASR |
$628.72
|
| Rate for Payer: ASR Commercial |
$628.72
|
| Rate for Payer: BCBS Complete |
$68.45
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$530.79
|
| Rate for Payer: BCN Commercial |
$502.53
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$609.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$648.17
|
| Rate for Payer: Healthscope Whirlpool |
$628.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$121.63
|
| Rate for Payer: Mclaren Commercial |
$583.35
|
| Rate for Payer: Mclaren Medicaid |
$65.19
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: Meridian Medicaid |
$68.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: Nomi Health Commercial |
$531.50
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$133.79
|
| Rate for Payer: PHP Medicaid |
$65.19
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$567.93
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health Narrow Network |
$454.37
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.63
|
| Rate for Payer: UHC Exchange |
$188.53
|
| Rate for Payer: UHC Medicare Advantage |
$121.63
|
| Rate for Payer: UHCCP DNSP |
$121.63
|
| Rate for Payer: UHCCP Medicaid |
$65.19
|
| Rate for Payer: VA VA |
$121.63
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
OP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.83 |
| Max. Negotiated Rate |
$412.00 |
| Rate for Payer: Aetna Commercial |
$370.80
|
| Rate for Payer: Aetna Medicare |
$91.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.58
|
| Rate for Payer: ASR ASR |
$399.64
|
| Rate for Payer: ASR Commercial |
$399.64
|
| Rate for Payer: BCBS Complete |
$51.59
|
| Rate for Payer: BCBS MAPPO |
$91.66
|
| Rate for Payer: BCBS Trust/PPO |
$337.39
|
| Rate for Payer: BCN Commercial |
$319.42
|
| Rate for Payer: BCN Medicare Advantage |
$91.66
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$387.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.66
|
| Rate for Payer: Healthscope Commercial |
$412.00
|
| Rate for Payer: Healthscope Whirlpool |
$399.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$91.66
|
| Rate for Payer: Mclaren Commercial |
$370.80
|
| Rate for Payer: Mclaren Medicaid |
$49.13
|
| Rate for Payer: Mclaren Medicare |
$91.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.24
|
| Rate for Payer: Meridian Medicaid |
$51.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: Nomi Health Commercial |
$337.84
|
| Rate for Payer: PACE Medicare |
$87.08
|
| Rate for Payer: PACE SWMI |
$91.66
|
| Rate for Payer: PHP Commercial |
$100.83
|
| Rate for Payer: PHP Medicaid |
$49.13
|
| Rate for Payer: PHP Medicare Advantage |
$91.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.79
|
| Rate for Payer: Priority Health Medicare |
$91.66
|
| Rate for Payer: Priority Health Narrow Network |
$47.83
|
| Rate for Payer: Railroad Medicare Medicare |
$91.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.66
|
| Rate for Payer: UHC Exchange |
$142.07
|
| Rate for Payer: UHC Medicare Advantage |
$91.66
|
| Rate for Payer: UHCCP DNSP |
$91.66
|
| Rate for Payer: UHCCP Medicaid |
$49.13
|
| Rate for Payer: VA VA |
$91.66
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
IP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$267.80 |
| Max. Negotiated Rate |
$412.00 |
| Rate for Payer: Aetna Commercial |
$370.80
|
| Rate for Payer: ASR ASR |
$399.64
|
| Rate for Payer: ASR Commercial |
$399.64
|
| Rate for Payer: BCBS Trust/PPO |
$335.74
|
| Rate for Payer: BCN Commercial |
$319.42
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$387.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Healthscope Commercial |
$412.00
|
| Rate for Payer: Healthscope Whirlpool |
$399.64
|
| Rate for Payer: Mclaren Commercial |
$370.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: Nomi Health Commercial |
$337.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.56
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
IP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,537.07 |
| Max. Negotiated Rate |
$2,364.72 |
| Rate for Payer: Aetna Commercial |
$2,128.25
|
| Rate for Payer: ASR ASR |
$2,293.78
|
| Rate for Payer: ASR Commercial |
$2,293.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.01
|
| Rate for Payer: BCN Commercial |
$1,833.37
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,222.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Healthscope Commercial |
$2,364.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,293.78
|
| Rate for Payer: Mclaren Commercial |
$2,128.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,080.95
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
OP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,364.72 |
| Rate for Payer: Aetna Commercial |
$2,128.25
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,293.78
|
| Rate for Payer: ASR Commercial |
$2,293.78
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,936.47
|
| Rate for Payer: BCN Commercial |
$1,833.37
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,222.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,364.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,293.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,128.25
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.07
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,693.14
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.51
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,080.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
IP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,371.79 |
| Max. Negotiated Rate |
$2,110.45 |
| Rate for Payer: Aetna Commercial |
$1,899.40
|
| Rate for Payer: ASR ASR |
$2,047.14
|
| Rate for Payer: ASR Commercial |
$2,047.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,719.81
|
| Rate for Payer: BCN Commercial |
$1,636.23
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,983.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Healthscope Commercial |
$2,110.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,047.14
|
| Rate for Payer: Mclaren Commercial |
$1,899.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,857.20
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
OP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,110.45 |
| Rate for Payer: Aetna Commercial |
$1,899.40
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$2,047.14
|
| Rate for Payer: ASR Commercial |
$2,047.14
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.25
|
| Rate for Payer: BCN Commercial |
$1,636.23
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,983.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,110.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,047.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,899.40
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.68
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,220.54
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,857.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
OP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,090.30 |
| Rate for Payer: Aetna Commercial |
$2,781.27
|
| Rate for Payer: Aetna Medicare |
$349.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: ASR ASR |
$2,997.59
|
| Rate for Payer: ASR Commercial |
$2,997.59
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,530.65
|
| Rate for Payer: BCN Commercial |
$2,395.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,904.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,090.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,997.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$349.91
|
| Rate for Payer: Mclaren Commercial |
$2,781.27
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: Nomi Health Commercial |
$2,534.05
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$384.90
|
| Rate for Payer: PHP Medicaid |
$187.55
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,064.27
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,651.42
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,719.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$542.36
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP DNSP |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
IP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,008.70 |
| Max. Negotiated Rate |
$3,090.30 |
| Rate for Payer: Aetna Commercial |
$2,781.27
|
| Rate for Payer: ASR ASR |
$2,997.59
|
| Rate for Payer: ASR Commercial |
$2,997.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,518.29
|
| Rate for Payer: BCN Commercial |
$2,395.91
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,904.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Healthscope Commercial |
$3,090.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,997.59
|
| Rate for Payer: Mclaren Commercial |
$2,781.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: Nomi Health Commercial |
$2,534.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,719.46
|
|
