|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$145.92 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| 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 |
$141.54
|
| Rate for Payer: ASR Commercial |
$141.54
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$119.49
|
| Rate for Payer: BCN Commercial |
$113.13
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$145.92
|
| Rate for Payer: Healthscope Whirlpool |
$141.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$131.33
|
| 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 |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| 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 |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.86
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$102.29
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.41
|
| 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 MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$145.92 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| Rate for Payer: ASR ASR |
$141.54
|
| Rate for Payer: ASR Commercial |
$141.54
|
| Rate for Payer: BCBS Trust/PPO |
$118.91
|
| Rate for Payer: BCN Commercial |
$113.13
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$145.92
|
| Rate for Payer: Healthscope Whirlpool |
$141.54
|
| Rate for Payer: Mclaren Commercial |
$131.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.41
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$145.92 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| 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 |
$141.54
|
| Rate for Payer: ASR Commercial |
$141.54
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$119.49
|
| Rate for Payer: BCN Commercial |
$113.13
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$145.92
|
| Rate for Payer: Healthscope Whirlpool |
$141.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$131.33
|
| 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 |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| 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 |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.86
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$102.29
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.41
|
| 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 MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$145.92 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| Rate for Payer: ASR ASR |
$141.54
|
| Rate for Payer: ASR Commercial |
$141.54
|
| Rate for Payer: BCBS Trust/PPO |
$118.91
|
| Rate for Payer: BCN Commercial |
$113.13
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$145.92
|
| Rate for Payer: Healthscope Whirlpool |
$141.54
|
| Rate for Payer: Mclaren Commercial |
$131.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.41
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$145.92 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| Rate for Payer: ASR ASR |
$141.54
|
| Rate for Payer: ASR Commercial |
$141.54
|
| Rate for Payer: BCBS Trust/PPO |
$118.91
|
| Rate for Payer: BCN Commercial |
$113.13
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$145.92
|
| Rate for Payer: Healthscope Whirlpool |
$141.54
|
| Rate for Payer: Mclaren Commercial |
$131.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.41
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$145.92 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| 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 |
$141.54
|
| Rate for Payer: ASR Commercial |
$141.54
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$119.49
|
| Rate for Payer: BCN Commercial |
$113.13
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$145.92
|
| Rate for Payer: Healthscope Whirlpool |
$141.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$131.33
|
| 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 |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| 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 |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.86
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$102.29
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.41
|
| 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 MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: ASR Commercial |
$21.19
|
| Rate for Payer: BCBS Trust/PPO |
$17.81
|
| Rate for Payer: BCN Commercial |
$16.94
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Whirlpool |
$21.19
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: ASR Commercial |
$21.19
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$17.89
|
| Rate for Payer: BCN Commercial |
$16.94
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Whirlpool |
$21.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.14
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$15.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$220.32
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$198.29
|
| Rate for Payer: ASR ASR |
$213.71
|
| Rate for Payer: ASR Commercial |
$213.71
|
| Rate for Payer: BCBS Trust/PPO |
$179.54
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$207.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.26
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Healthscope Whirlpool |
$213.71
|
| Rate for Payer: Mclaren Commercial |
$198.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.27
|
| Rate for Payer: Nomi Health Commercial |
$180.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.88
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$220.32
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$198.29
|
| 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 |
$213.71
|
| Rate for Payer: ASR Commercial |
$213.71
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$180.42
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$207.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Healthscope Whirlpool |
$213.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$198.29
|
| 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 |
$187.27
|
| Rate for Payer: Nomi Health Commercial |
$180.66
|
| 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 |
$143.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.04
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$154.44
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.88
|
| 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 MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$645.05
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$94.01 |
| Max. Negotiated Rate |
$645.05 |
| Rate for Payer: Aetna Commercial |
$580.54
|
| Rate for Payer: Aetna Medicare |
$175.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: ASR ASR |
$625.70
|
| Rate for Payer: ASR Commercial |
$625.70
|
| Rate for Payer: BCBS Complete |
$98.72
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCBS Trust/PPO |
$528.23
|
| Rate for Payer: BCN Commercial |
$500.11
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$606.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$645.05
|
| Rate for Payer: Healthscope Whirlpool |
$625.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$175.40
|
| Rate for Payer: Mclaren Commercial |
$580.54
|
| Rate for Payer: Mclaren Medicaid |
$94.01
|
| Rate for Payer: Mclaren Medicare |
$175.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: Meridian Medicaid |
$98.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.29
|
| Rate for Payer: Nomi Health Commercial |
$528.94
|
| Rate for Payer: PACE Medicare |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$192.94
|
| Rate for Payer: PHP Medicaid |
$94.01
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$175.40
|
| Rate for Payer: Priority Health Narrow Network |
$452.18
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.40
|
| Rate for Payer: UHC Exchange |
$271.87
|
| Rate for Payer: UHC Medicare Advantage |
$175.40
|
| Rate for Payer: UHCCP DNSP |
$175.40
|
| Rate for Payer: UHCCP Medicaid |
$94.01
|
| Rate for Payer: VA VA |
$175.40
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$645.05
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$419.28 |
| Max. Negotiated Rate |
$645.05 |
| Rate for Payer: Aetna Commercial |
$580.54
|
| Rate for Payer: ASR ASR |
$625.70
|
| Rate for Payer: ASR Commercial |
$625.70
|
| Rate for Payer: BCBS Trust/PPO |
$525.65
|
| Rate for Payer: BCN Commercial |
$500.11
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$606.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.04
|
| Rate for Payer: Healthscope Commercial |
$645.05
|
| Rate for Payer: Healthscope Whirlpool |
$625.70
|
| Rate for Payer: Mclaren Commercial |
$580.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.29
|
| Rate for Payer: Nomi Health Commercial |
$528.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.64
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: ASR Commercial |
$121.10
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$102.24
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$124.85
|
| Rate for Payer: Healthscope Whirlpool |
$121.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.39
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$87.52
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: ASR Commercial |
$121.10
|
| Rate for Payer: BCBS Trust/PPO |
$101.74
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$124.85
|
| Rate for Payer: Healthscope Whirlpool |
$121.10
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$174.79 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$169.55
|
| Rate for Payer: ASR Commercial |
$169.55
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$143.14
|
| Rate for Payer: BCN Commercial |
$135.51
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$164.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$174.79
|
| Rate for Payer: Healthscope Whirlpool |
$169.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$157.31
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.15
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$122.53
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$113.61 |
| Max. Negotiated Rate |
$174.79 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: ASR ASR |
$169.55
|
| Rate for Payer: ASR Commercial |
$169.55
|
| Rate for Payer: BCBS Trust/PPO |
$142.44
|
| Rate for Payer: BCN Commercial |
$135.51
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$164.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$174.79
|
| Rate for Payer: Healthscope Whirlpool |
$169.55
|
| Rate for Payer: Mclaren Commercial |
$157.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.82
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$52.24 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: ASR ASR |
$50.67
|
| Rate for Payer: ASR Commercial |
$50.67
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$42.78
|
| Rate for Payer: BCN Commercial |
$40.50
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$52.24
|
| Rate for Payer: Healthscope Whirlpool |
$50.67
|
| Rate for Payer: Mclaren Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.77
|
| Rate for Payer: Priority Health Narrow Network |
$36.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.97
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$52.24 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: ASR ASR |
$50.67
|
| Rate for Payer: ASR Commercial |
$50.67
|
| Rate for Payer: BCBS Trust/PPO |
$42.57
|
| Rate for Payer: BCN Commercial |
$40.50
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$52.24
|
| Rate for Payer: Healthscope Whirlpool |
$50.67
|
| Rate for Payer: Mclaren Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.97
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$52.24 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: Aetna Medicare |
$26.12
|
| Rate for Payer: ASR ASR |
$50.67
|
| Rate for Payer: ASR Commercial |
$50.67
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS Trust/PPO |
$42.78
|
| Rate for Payer: BCN Commercial |
$40.50
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$52.24
|
| Rate for Payer: Healthscope Whirlpool |
$50.67
|
| Rate for Payer: Mclaren Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.77
|
| Rate for Payer: Priority Health Narrow Network |
$36.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.97
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$52.24 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: ASR ASR |
$50.67
|
| Rate for Payer: ASR Commercial |
$50.67
|
| Rate for Payer: BCBS Trust/PPO |
$42.57
|
| Rate for Payer: BCN Commercial |
$40.50
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$52.24
|
| Rate for Payer: Healthscope Whirlpool |
$50.67
|
| Rate for Payer: Mclaren Commercial |
$47.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.97
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
OP
|
$30.17
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$30.17 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$29.26
|
| Rate for Payer: ASR Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$24.71
|
| Rate for Payer: BCN Commercial |
$23.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$28.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$30.17
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$27.15
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$21.15
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$30.17
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$30.17 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: ASR ASR |
$29.26
|
| Rate for Payer: ASR Commercial |
$29.26
|
| Rate for Payer: BCBS Trust/PPO |
$24.59
|
| Rate for Payer: BCN Commercial |
$23.39
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$28.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$30.17
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Mclaren Commercial |
$27.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.55
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
OP
|
$34.70
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$34.70 |
| Rate for Payer: Aetna Commercial |
$31.23
|
| Rate for Payer: Aetna Medicare |
$13.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.61
|
| Rate for Payer: ASR ASR |
$33.66
|
| Rate for Payer: ASR Commercial |
$33.66
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.29
|
| Rate for Payer: BCBS Trust/PPO |
$28.42
|
| Rate for Payer: BCN Commercial |
$26.90
|
| Rate for Payer: BCN Medicare Advantage |
$13.29
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cofinity Commercial |
$32.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.29
|
| Rate for Payer: Healthscope Commercial |
$34.70
|
| Rate for Payer: Healthscope Whirlpool |
$33.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.29
|
| Rate for Payer: Mclaren Commercial |
$31.23
|
| Rate for Payer: Mclaren Medicaid |
$7.12
|
| Rate for Payer: Mclaren Medicare |
$13.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.95
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: PACE Medicare |
$12.63
|
| Rate for Payer: PACE SWMI |
$13.29
|
| Rate for Payer: PHP Commercial |
$14.62
|
| Rate for Payer: PHP Medicaid |
$7.12
|
| Rate for Payer: PHP Medicare Advantage |
$13.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.40
|
| Rate for Payer: Priority Health Medicare |
$13.29
|
| Rate for Payer: Priority Health Narrow Network |
$24.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.29
|
| Rate for Payer: UHC Exchange |
$20.60
|
| Rate for Payer: UHC Medicare Advantage |
$13.29
|
| Rate for Payer: UHCCP DNSP |
$13.29
|
| Rate for Payer: UHCCP Medicaid |
$7.12
|
| Rate for Payer: VA VA |
$13.29
|
|
