|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,296.89 |
| Max. Negotiated Rate |
$1,995.22 |
| Rate for Payer: Aetna Commercial |
$1,795.70
|
| Rate for Payer: Aetna Commercial |
$2,693.55
|
| Rate for Payer: ASR ASR |
$2,903.05
|
| Rate for Payer: ASR ASR |
$1,935.36
|
| Rate for Payer: ASR Commercial |
$2,903.05
|
| Rate for Payer: ASR Commercial |
$1,935.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,438.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.90
|
| Rate for Payer: BCN Commercial |
$2,320.34
|
| Rate for Payer: BCN Commercial |
$1,546.89
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,813.26
|
| Rate for Payer: Cofinity Commercial |
$1,875.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Healthscope Commercial |
$1,995.22
|
| Rate for Payer: Healthscope Commercial |
$2,992.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,903.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.36
|
| Rate for Payer: Mclaren Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Commercial |
$2,693.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.69
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,992.83
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,992.83 |
| Rate for Payer: Aetna Commercial |
$2,693.55
|
| Rate for Payer: Aetna Commercial |
$1,795.70
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$2,903.05
|
| Rate for Payer: ASR ASR |
$1,935.36
|
| Rate for Payer: ASR Commercial |
$1,935.36
|
| Rate for Payer: ASR Commercial |
$2,903.05
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.83
|
| Rate for Payer: BCN Commercial |
$1,546.89
|
| Rate for Payer: BCN Commercial |
$2,320.34
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$2,813.26
|
| Rate for Payer: Cofinity Commercial |
$1,875.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,992.83
|
| Rate for Payer: Healthscope Commercial |
$1,995.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,903.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,795.70
|
| Rate for Payer: Mclaren Commercial |
$2,693.55
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,748.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,622.32
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,097.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,398.65
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,436.30 |
| Rate for Payer: Aetna Commercial |
$3,092.67
|
| Rate for Payer: Aetna Commercial |
$2,061.77
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$3,333.21
|
| Rate for Payer: ASR ASR |
$2,222.13
|
| Rate for Payer: ASR Commercial |
$2,222.13
|
| Rate for Payer: ASR Commercial |
$3,333.21
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,813.99
|
| Rate for Payer: BCN Commercial |
$1,776.10
|
| Rate for Payer: BCN Commercial |
$2,664.16
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cofinity Commercial |
$3,230.12
|
| Rate for Payer: Cofinity Commercial |
$2,153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,436.30
|
| Rate for Payer: Healthscope Commercial |
$2,290.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,222.13
|
| Rate for Payer: Healthscope Whirlpool |
$3,333.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Commercial |
$3,092.67
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,007.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,010.89
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,408.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.89
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,023.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,489.06 |
| Max. Negotiated Rate |
$2,290.86 |
| Rate for Payer: Aetna Commercial |
$2,061.77
|
| Rate for Payer: Aetna Commercial |
$3,092.67
|
| Rate for Payer: ASR ASR |
$3,333.21
|
| Rate for Payer: ASR ASR |
$2,222.13
|
| Rate for Payer: ASR Commercial |
$3,333.21
|
| Rate for Payer: ASR Commercial |
$2,222.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,800.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.82
|
| Rate for Payer: BCN Commercial |
$2,664.16
|
| Rate for Payer: BCN Commercial |
$1,776.10
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$3,230.12
|
| Rate for Payer: Cofinity Commercial |
$2,153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Healthscope Commercial |
$2,290.86
|
| Rate for Payer: Healthscope Commercial |
$3,436.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,333.21
|
| Rate for Payer: Healthscope Whirlpool |
$2,222.13
|
| Rate for Payer: Mclaren Commercial |
$2,061.77
|
| Rate for Payer: Mclaren Commercial |
$3,092.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,023.94
|
|
|
HC MSMART BM CMPT1
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: Aetna Medicare |
$52.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: ASR ASR |
$237.46
|
| Rate for Payer: ASR Commercial |
$237.46
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$200.47
|
| Rate for Payer: BCN Commercial |
$189.79
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$230.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$244.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.11
|
| Rate for Payer: Mclaren Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$57.32
|
| Rate for Payer: PHP Medicaid |
$27.93
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.49
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health Narrow Network |
$171.60
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP DNSP |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC MSMART BM CMPT1
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$159.12 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: ASR ASR |
$237.46
|
| Rate for Payer: ASR Commercial |
$237.46
|
| Rate for Payer: BCBS Trust/PPO |
$199.49
|
| Rate for Payer: BCN Commercial |
$189.79
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$230.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$244.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.46
|
| Rate for Payer: Mclaren Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.42
|
|
|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$543.79 |
| Rate for Payer: Aetna Commercial |
$153.70
|
| Rate for Payer: Aetna Medicare |
$350.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: ASR ASR |
$165.66
|
| Rate for Payer: ASR Commercial |
$165.66
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCBS Trust/PPO |
$139.85
|
| Rate for Payer: BCN Commercial |
$132.41
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| 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 |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$170.78
|
| Rate for Payer: Healthscope Whirlpool |
$165.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$350.83
|
| Rate for Payer: Mclaren Commercial |
$153.70
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$385.91
|
| Rate for Payer: PHP Medicaid |
$188.04
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.64
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health Narrow Network |
$119.72
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Exchange |
$543.79
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP DNSP |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$188.04
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
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 MSMART BM CMPT3
|
Facility
|
IP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$114.70 |
| Max. Negotiated Rate |
$176.46 |
| Rate for Payer: Aetna Commercial |
$158.81
|
| Rate for Payer: ASR ASR |
$171.17
|
| Rate for Payer: ASR Commercial |
$171.17
|
| Rate for Payer: BCBS Trust/PPO |
$143.80
|
| Rate for Payer: BCN Commercial |
$136.81
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$165.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$176.46
|
| Rate for Payer: Healthscope Whirlpool |
$171.17
|
| Rate for Payer: Mclaren Commercial |
$158.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$144.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.28
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$70.58 |
| Max. Negotiated Rate |
$176.46 |
| Rate for Payer: Aetna Commercial |
$158.81
|
| Rate for Payer: Aetna Medicare |
$88.23
|
| Rate for Payer: ASR ASR |
$171.17
|
| Rate for Payer: ASR Commercial |
$171.17
|
| Rate for Payer: BCBS Complete |
$70.58
|
| Rate for Payer: BCBS Trust/PPO |
$144.50
|
| Rate for Payer: BCN Commercial |
$136.81
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$165.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$176.46
|
| Rate for Payer: Healthscope Whirlpool |
$171.17
|
| Rate for Payer: Mclaren Commercial |
$158.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$144.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.61
|
| Rate for Payer: Priority Health Narrow Network |
$123.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.28
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$68.18 |
| Rate for Payer: Aetna Commercial |
$61.36
|
| Rate for Payer: Aetna Medicare |
$41.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: ASR ASR |
$66.13
|
| Rate for Payer: ASR Commercial |
$66.13
|
| Rate for Payer: BCBS Complete |
$23.46
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$55.83
|
| Rate for Payer: BCN Commercial |
$52.86
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$64.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$68.18
|
| Rate for Payer: Healthscope Whirlpool |
$66.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$41.68
|
| Rate for Payer: Mclaren Commercial |
$61.36
|
| Rate for Payer: Mclaren Medicaid |
$22.34
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: Meridian Medicaid |
$23.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: Nomi Health Commercial |
$55.91
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$45.85
|
| Rate for Payer: PHP Medicaid |
$22.34
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$47.79
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Exchange |
$64.60
|
| Rate for Payer: UHC Medicare Advantage |
$41.68
|
| Rate for Payer: UHCCP DNSP |
$41.68
|
| Rate for Payer: UHCCP Medicaid |
$22.34
|
| Rate for Payer: VA VA |
$41.68
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.32 |
| Max. Negotiated Rate |
$68.18 |
| Rate for Payer: Aetna Commercial |
$61.36
|
| Rate for Payer: ASR ASR |
$66.13
|
| Rate for Payer: ASR Commercial |
$66.13
|
| Rate for Payer: BCBS Trust/PPO |
$55.56
|
| Rate for Payer: BCN Commercial |
$52.86
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$64.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Healthscope Commercial |
$68.18
|
| Rate for Payer: Healthscope Whirlpool |
$66.13
|
| Rate for Payer: Mclaren Commercial |
$61.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: Nomi Health Commercial |
$55.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.00
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$57.40 |
| Rate for Payer: Aetna Commercial |
$51.66
|
| Rate for Payer: ASR ASR |
$55.68
|
| Rate for Payer: ASR Commercial |
$55.68
|
| Rate for Payer: BCBS Trust/PPO |
$46.78
|
| Rate for Payer: BCN Commercial |
$44.50
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$53.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$57.40
|
| Rate for Payer: Healthscope Whirlpool |
$55.68
|
| Rate for Payer: Mclaren Commercial |
$51.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.51
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$57.40 |
| Rate for Payer: Aetna Commercial |
$51.66
|
| 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 |
$55.68
|
| Rate for Payer: ASR Commercial |
$55.68
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$47.00
|
| Rate for Payer: BCN Commercial |
$44.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$53.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$57.40
|
| Rate for Payer: Healthscope Whirlpool |
$55.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$51.66
|
| 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 |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| 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 |
$37.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.29
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$40.24
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.51
|
| 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 MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$506.94
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$506.94 |
| Rate for Payer: Aetna Commercial |
$456.25
|
| Rate for Payer: Aetna Medicare |
$65.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.67
|
| Rate for Payer: ASR ASR |
$491.73
|
| Rate for Payer: ASR Commercial |
$491.73
|
| Rate for Payer: BCBS Complete |
$36.77
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCBS Trust/PPO |
$415.13
|
| Rate for Payer: BCN Commercial |
$393.03
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cofinity Commercial |
$476.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$506.94
|
| Rate for Payer: Healthscope Whirlpool |
$491.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$65.34
|
| Rate for Payer: Mclaren Commercial |
$456.25
|
| Rate for Payer: Mclaren Medicaid |
$35.02
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: Meridian Medicaid |
$36.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.90
|
| Rate for Payer: Nomi Health Commercial |
$415.69
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$71.87
|
| Rate for Payer: PHP Medicaid |
$35.02
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$444.18
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$355.36
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$101.28
|
| Rate for Payer: UHC Medicare Advantage |
$65.34
|
| Rate for Payer: UHCCP DNSP |
$65.34
|
| Rate for Payer: UHCCP Medicaid |
$35.02
|
| Rate for Payer: VA VA |
$65.34
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$506.94
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$329.51 |
| Max. Negotiated Rate |
$506.94 |
| Rate for Payer: Aetna Commercial |
$456.25
|
| Rate for Payer: ASR ASR |
$491.73
|
| Rate for Payer: ASR Commercial |
$491.73
|
| Rate for Payer: BCBS Trust/PPO |
$413.11
|
| Rate for Payer: BCN Commercial |
$393.03
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cofinity Commercial |
$476.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.55
|
| Rate for Payer: Healthscope Commercial |
$506.94
|
| Rate for Payer: Healthscope Whirlpool |
$491.73
|
| Rate for Payer: Mclaren Commercial |
$456.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.90
|
| Rate for Payer: Nomi Health Commercial |
$415.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.11
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$382.50
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: Aetna Medicare |
$65.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.67
|
| Rate for Payer: ASR ASR |
$371.02
|
| Rate for Payer: ASR Commercial |
$371.02
|
| Rate for Payer: BCBS Complete |
$36.77
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCBS Trust/PPO |
$313.23
|
| Rate for Payer: BCN Commercial |
$296.55
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$359.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$382.50
|
| Rate for Payer: Healthscope Whirlpool |
$371.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$65.34
|
| Rate for Payer: Mclaren Commercial |
$344.25
|
| Rate for Payer: Mclaren Medicaid |
$35.02
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: Meridian Medicaid |
$36.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$313.65
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$71.87
|
| Rate for Payer: PHP Medicaid |
$35.02
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.15
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$268.13
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$101.28
|
| Rate for Payer: UHC Medicare Advantage |
$65.34
|
| Rate for Payer: UHCCP DNSP |
$65.34
|
| Rate for Payer: UHCCP Medicaid |
$35.02
|
| Rate for Payer: VA VA |
$65.34
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$382.50
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$248.62 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: ASR ASR |
$371.02
|
| Rate for Payer: ASR Commercial |
$371.02
|
| Rate for Payer: BCBS Trust/PPO |
$311.70
|
| Rate for Payer: BCN Commercial |
$296.55
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$359.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$382.50
|
| Rate for Payer: Healthscope Whirlpool |
$371.02
|
| Rate for Payer: Mclaren Commercial |
$344.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$313.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.60
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$197.88
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$128.62 |
| Max. Negotiated Rate |
$197.88 |
| Rate for Payer: Aetna Commercial |
$178.09
|
| Rate for Payer: ASR ASR |
$191.94
|
| Rate for Payer: ASR Commercial |
$191.94
|
| Rate for Payer: BCBS Trust/PPO |
$161.25
|
| Rate for Payer: BCN Commercial |
$153.42
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cofinity Commercial |
$186.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.30
|
| Rate for Payer: Healthscope Commercial |
$197.88
|
| Rate for Payer: Healthscope Whirlpool |
$191.94
|
| Rate for Payer: Mclaren Commercial |
$178.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.20
|
| Rate for Payer: Nomi Health Commercial |
$162.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.13
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$197.88
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$197.88 |
| Rate for Payer: Aetna Commercial |
$178.09
|
| Rate for Payer: Aetna Medicare |
$41.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: ASR ASR |
$191.94
|
| Rate for Payer: ASR Commercial |
$191.94
|
| Rate for Payer: BCBS Complete |
$23.46
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$162.04
|
| Rate for Payer: BCN Commercial |
$153.42
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cofinity Commercial |
$186.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$197.88
|
| Rate for Payer: Healthscope Whirlpool |
$191.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$41.68
|
| Rate for Payer: Mclaren Commercial |
$178.09
|
| Rate for Payer: Mclaren Medicaid |
$22.34
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: Meridian Medicaid |
$23.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.20
|
| Rate for Payer: Nomi Health Commercial |
$162.26
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$45.85
|
| Rate for Payer: PHP Medicaid |
$22.34
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.38
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$138.71
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Exchange |
$64.60
|
| Rate for Payer: UHC Medicare Advantage |
$41.68
|
| Rate for Payer: UHCCP DNSP |
$41.68
|
| Rate for Payer: UHCCP Medicaid |
$22.34
|
| Rate for Payer: VA VA |
$41.68
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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 MUCORE RACEMOSUS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 MUGWORT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
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 MUGWORT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 MULBERRY IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
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
|
|
