|
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 |
$81.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.68
|
| 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 |
$80.24
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$64.19
|
| 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
|
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 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 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 |
$6.52
|
| 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 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 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 |
$6.52
|
| 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 MULBERRY IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
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 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
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$6.68
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$6.68 |
| Rate for Payer: Aetna Commercial |
$6.01
|
| Rate for Payer: ASR ASR |
$6.48
|
| Rate for Payer: ASR Commercial |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.44
|
| Rate for Payer: BCN Commercial |
$5.18
|
| Rate for Payer: Cash Price |
$5.34
|
| Rate for Payer: Cofinity Commercial |
$6.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.34
|
| Rate for Payer: Healthscope Commercial |
$6.68
|
| Rate for Payer: Healthscope Whirlpool |
$6.48
|
| Rate for Payer: Mclaren Commercial |
$6.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.68
|
| Rate for Payer: Nomi Health Commercial |
$5.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.88
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
OP
|
$6.68
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$6.68 |
| Rate for Payer: Aetna Commercial |
$6.01
|
| Rate for Payer: Aetna Medicare |
$3.34
|
| Rate for Payer: ASR ASR |
$6.48
|
| Rate for Payer: ASR Commercial |
$6.48
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS Trust/PPO |
$5.47
|
| Rate for Payer: BCN Commercial |
$5.18
|
| Rate for Payer: Cash Price |
$5.34
|
| Rate for Payer: Cash Price |
$5.34
|
| Rate for Payer: Cofinity Commercial |
$6.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.34
|
| Rate for Payer: Healthscope Commercial |
$6.68
|
| Rate for Payer: Healthscope Whirlpool |
$6.48
|
| Rate for Payer: Mclaren Commercial |
$6.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.68
|
| Rate for Payer: Nomi Health Commercial |
$5.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.88
|
| Rate for Payer: Priority Health Narrow Network |
$1.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.88
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$641.58
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$417.03 |
| Max. Negotiated Rate |
$641.58 |
| Rate for Payer: Aetna Commercial |
$577.42
|
| Rate for Payer: ASR ASR |
$622.33
|
| Rate for Payer: ASR Commercial |
$622.33
|
| Rate for Payer: BCBS Trust/PPO |
$522.82
|
| Rate for Payer: BCN Commercial |
$497.42
|
| Rate for Payer: Cash Price |
$513.26
|
| Rate for Payer: Cofinity Commercial |
$603.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.26
|
| Rate for Payer: Healthscope Commercial |
$641.58
|
| Rate for Payer: Healthscope Whirlpool |
$622.33
|
| Rate for Payer: Mclaren Commercial |
$577.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.34
|
| Rate for Payer: Nomi Health Commercial |
$526.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.59
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$641.58
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$641.58 |
| Rate for Payer: Aetna Commercial |
$577.42
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$622.33
|
| Rate for Payer: ASR Commercial |
$622.33
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$525.39
|
| Rate for Payer: BCN Commercial |
$497.42
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$513.26
|
| Rate for Payer: Cash Price |
$513.26
|
| Rate for Payer: Cofinity Commercial |
$603.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$641.58
|
| Rate for Payer: Healthscope Whirlpool |
$622.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$577.42
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.34
|
| Rate for Payer: Nomi Health Commercial |
$526.10
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$562.15
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$449.75
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
OP
|
$853.13
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$192.25 |
| Max. Negotiated Rate |
$853.13 |
| Rate for Payer: Aetna Commercial |
$767.82
|
| Rate for Payer: Aetna Medicare |
$358.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: ASR ASR |
$827.54
|
| Rate for Payer: ASR Commercial |
$827.54
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$698.63
|
| Rate for Payer: BCN Commercial |
$661.43
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| Rate for Payer: Cash Price |
$682.50
|
| Rate for Payer: Cash Price |
$682.50
|
| Rate for Payer: Cofinity Commercial |
$801.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.67
|
| Rate for Payer: Healthscope Commercial |
$853.13
|
| Rate for Payer: Healthscope Whirlpool |
$827.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$358.67
|
| Rate for Payer: Mclaren Commercial |
$767.82
|
| Rate for Payer: Mclaren Medicaid |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.16
|
| Rate for Payer: Nomi Health Commercial |
$699.57
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$394.54
|
| Rate for Payer: PHP Medicaid |
$192.25
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$747.51
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$598.04
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$750.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$555.94
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP DNSP |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: VA VA |
$358.67
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
IP
|
$853.13
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$554.53 |
| Max. Negotiated Rate |
$853.13 |
| Rate for Payer: Aetna Commercial |
$767.82
|
| Rate for Payer: ASR ASR |
$827.54
|
| Rate for Payer: ASR Commercial |
$827.54
|
| Rate for Payer: BCBS Trust/PPO |
$695.22
|
| Rate for Payer: BCN Commercial |
$661.43
|
| Rate for Payer: Cash Price |
$682.50
|
| Rate for Payer: Cofinity Commercial |
$801.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.50
|
| Rate for Payer: Healthscope Commercial |
$853.13
|
| Rate for Payer: Healthscope Whirlpool |
$827.54
|
| Rate for Payer: Mclaren Commercial |
$767.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.16
|
| Rate for Payer: Nomi Health Commercial |
$699.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$750.75
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
OP
|
$122.48
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$122.48 |
| Rate for Payer: Aetna Commercial |
$110.23
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$118.81
|
| Rate for Payer: ASR Commercial |
$118.81
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$100.30
|
| Rate for Payer: BCN Commercial |
$94.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$97.98
|
| Rate for Payer: Cash Price |
$97.98
|
| Rate for Payer: Cofinity Commercial |
$115.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$122.48
|
| Rate for Payer: Healthscope Whirlpool |
$118.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$110.23
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.11
|
| Rate for Payer: Nomi Health Commercial |
$100.43
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.32
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$85.86
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC MULTIPLE SCLEROSIS PROFILE
|
Facility
|
IP
|
$122.48
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100744
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.61 |
| Max. Negotiated Rate |
$122.48 |
| Rate for Payer: Aetna Commercial |
$110.23
|
| Rate for Payer: ASR ASR |
$118.81
|
| Rate for Payer: ASR Commercial |
$118.81
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$94.96
|
| Rate for Payer: Cash Price |
$97.98
|
| Rate for Payer: Cofinity Commercial |
$115.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.98
|
| Rate for Payer: Healthscope Commercial |
$122.48
|
| Rate for Payer: Healthscope Whirlpool |
$118.81
|
| Rate for Payer: Mclaren Commercial |
$110.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.11
|
| Rate for Payer: Nomi Health Commercial |
$100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.78
|
|
|
HC MUMPS AB IGG
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: Aetna Medicare |
$13.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: ASR Commercial |
$78.16
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$65.99
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.05
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Mclaren Medicaid |
$6.99
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: Meridian Medicaid |
$7.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: PHP Medicaid |
$6.99
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.12
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health Narrow Network |
$36.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.05
|
| Rate for Payer: UHC Exchange |
$20.23
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: UHCCP DNSP |
$13.05
|
| Rate for Payer: UHCCP Medicaid |
$6.99
|
| Rate for Payer: VA VA |
$13.05
|
|
|
HC MUMPS AB IGG
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.38 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: ASR Commercial |
$78.16
|
| Rate for Payer: BCBS Trust/PPO |
$65.66
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
OP
|
$77.52
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$77.52 |
| Rate for Payer: Aetna Commercial |
$69.77
|
| Rate for Payer: Aetna Medicare |
$13.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: ASR ASR |
$75.19
|
| Rate for Payer: ASR Commercial |
$75.19
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$63.48
|
| Rate for Payer: BCN Commercial |
$60.10
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cofinity Commercial |
$72.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$77.52
|
| Rate for Payer: Healthscope Whirlpool |
$75.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.05
|
| Rate for Payer: Mclaren Commercial |
$69.77
|
| Rate for Payer: Mclaren Medicaid |
$6.99
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: Meridian Medicaid |
$7.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.89
|
| Rate for Payer: Nomi Health Commercial |
$63.57
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: PHP Medicaid |
$6.99
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.12
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health Narrow Network |
$36.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.05
|
| Rate for Payer: UHC Exchange |
$20.23
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: UHCCP DNSP |
$13.05
|
| Rate for Payer: UHCCP Medicaid |
$6.99
|
| Rate for Payer: VA VA |
$13.05
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
IP
|
$77.52
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.39 |
| Max. Negotiated Rate |
$77.52 |
| Rate for Payer: Aetna Commercial |
$69.77
|
| Rate for Payer: ASR ASR |
$75.19
|
| Rate for Payer: ASR Commercial |
$75.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.17
|
| Rate for Payer: BCN Commercial |
$60.10
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cofinity Commercial |
$72.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.02
|
| Rate for Payer: Healthscope Commercial |
$77.52
|
| Rate for Payer: Healthscope Whirlpool |
$75.19
|
| Rate for Payer: Mclaren Commercial |
$69.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.89
|
| Rate for Payer: Nomi Health Commercial |
$63.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.22
|
|
|
HC MYCOBACTERIUM TUBERCULOSIS, RIFAMPIN RESISTANCE, AMP PROBE
|
Facility
|
IP
|
$117.50
|
|
|
Service Code
|
CPT 87564
|
| Hospital Charge Code |
30600345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$76.38 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$105.75
|
| Rate for Payer: ASR ASR |
$113.98
|
| Rate for Payer: ASR Commercial |
$113.98
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$91.10
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cofinity Commercial |
$110.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.00
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Healthscope Whirlpool |
$113.98
|
| Rate for Payer: Mclaren Commercial |
$105.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.88
|
| Rate for Payer: Nomi Health Commercial |
$96.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.40
|
|
|
HC MYCOBACTERIUM TUBERCULOSIS, RIFAMPIN RESISTANCE, AMP PROBE
|
Facility
|
OP
|
$117.50
|
|
|
Service Code
|
CPT 87564
|
| Hospital Charge Code |
30600345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$41.15 |
| Max. Negotiated Rate |
$118.99 |
| Rate for Payer: Aetna Commercial |
$105.75
|
| Rate for Payer: Aetna Medicare |
$76.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.96
|
| Rate for Payer: ASR ASR |
$113.98
|
| Rate for Payer: ASR Commercial |
$113.98
|
| Rate for Payer: BCBS Complete |
$43.21
|
| Rate for Payer: BCBS MAPPO |
$76.77
|
| Rate for Payer: BCBS Trust/PPO |
$96.22
|
| Rate for Payer: BCN Commercial |
$91.10
|
| Rate for Payer: BCN Medicare Advantage |
$76.77
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cofinity Commercial |
$110.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.77
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Healthscope Whirlpool |
$113.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$76.77
|
| Rate for Payer: Mclaren Commercial |
$105.75
|
| Rate for Payer: Mclaren Medicaid |
$41.15
|
| Rate for Payer: Mclaren Medicare |
$76.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.61
|
| Rate for Payer: Meridian Medicaid |
$43.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.88
|
| Rate for Payer: Nomi Health Commercial |
$96.35
|
| Rate for Payer: PACE Medicare |
$72.93
|
| Rate for Payer: PACE SWMI |
$76.77
|
| Rate for Payer: PHP Commercial |
$84.45
|
| Rate for Payer: PHP Medicaid |
$41.15
|
| Rate for Payer: PHP Medicare Advantage |
$76.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.77
|
| Rate for Payer: Priority Health Medicare |
$76.77
|
| Rate for Payer: Priority Health Narrow Network |
$61.42
|
| Rate for Payer: Railroad Medicare Medicare |
$76.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.77
|
| Rate for Payer: UHC Exchange |
$118.99
|
| Rate for Payer: UHC Medicare Advantage |
$76.77
|
| Rate for Payer: UHCCP DNSP |
$76.77
|
| Rate for Payer: UHCCP Medicaid |
$41.15
|
| Rate for Payer: VA VA |
$76.77
|
|
