|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$24.51
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$37.96 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$24.51
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.96
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$30.37
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: ASR ASR |
$77.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.02
|
| Rate for Payer: BCN Commercial |
$62.02
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$75.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$80.00
|
| Rate for Payer: Healthscope Whirlpool |
$77.60
|
| Rate for Payer: Mclaren Commercial |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.40
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| 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 |
$77.60
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$62.02
|
| Rate for Payer: BCN Commercial |
$62.02
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$75.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$80.00
|
| Rate for Payer: Healthscope Whirlpool |
$77.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$72.00
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| 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 |
$7.24
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.36
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$42.69
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.90 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Medicare |
$18.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.61
|
| Rate for Payer: ASR ASR |
$48.50
|
| Rate for Payer: BCBS Complete |
$10.39
|
| Rate for Payer: BCBS MAPPO |
$18.09
|
| Rate for Payer: BCBS Trust/PPO |
$38.76
|
| Rate for Payer: BCN Commercial |
$38.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.09
|
| Rate for Payer: Healthscope Commercial |
$50.00
|
| Rate for Payer: Healthscope Whirlpool |
$48.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.09
|
| Rate for Payer: Mclaren Commercial |
$45.00
|
| Rate for Payer: Mclaren Medicaid |
$9.90
|
| Rate for Payer: Mclaren Medicare |
$18.09
|
| Rate for Payer: Meridian Medicaid |
$10.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.50
|
| Rate for Payer: PACE Medicare |
$17.19
|
| Rate for Payer: PACE SWMI |
$18.09
|
| Rate for Payer: PHP Commercial |
$19.90
|
| Rate for Payer: PHP Medicaid |
$9.90
|
| Rate for Payer: PHP Medicare Advantage |
$18.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.50
|
| Rate for Payer: Priority Health Medicare |
$18.09
|
| Rate for Payer: Priority Health Narrow Network |
$35.50
|
| Rate for Payer: Railroad Medicare Medicare |
$18.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.00
|
| Rate for Payer: UHC Medicare Advantage |
$18.63
|
| Rate for Payer: VA VA |
$18.09
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: ASR ASR |
$48.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.76
|
| Rate for Payer: BCN Commercial |
$38.76
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$50.00
|
| Rate for Payer: Healthscope Whirlpool |
$48.50
|
| Rate for Payer: Mclaren Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.00
|
|
|
HC T3 FREE
|
Facility
|
OP
|
$129.60
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$129.60 |
| Rate for Payer: Aetna Commercial |
$116.64
|
| Rate for Payer: Aetna Medicare |
$16.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.18
|
| Rate for Payer: ASR ASR |
$125.71
|
| Rate for Payer: BCBS Complete |
$9.73
|
| Rate for Payer: BCBS MAPPO |
$16.94
|
| Rate for Payer: BCBS Trust/PPO |
$100.48
|
| Rate for Payer: BCN Commercial |
$100.48
|
| Rate for Payer: BCN Medicare Advantage |
$16.94
|
| Rate for Payer: Cash Price |
$103.68
|
| Rate for Payer: Cash Price |
$103.68
|
| Rate for Payer: Cofinity Commercial |
$121.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$129.60
|
| Rate for Payer: Healthscope Whirlpool |
$125.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.94
|
| Rate for Payer: Mclaren Commercial |
$116.64
|
| Rate for Payer: Mclaren Medicaid |
$9.27
|
| Rate for Payer: Mclaren Medicare |
$16.94
|
| Rate for Payer: Meridian Medicaid |
$9.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.16
|
| Rate for Payer: PACE Medicare |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.94
|
| Rate for Payer: PHP Commercial |
$18.63
|
| Rate for Payer: PHP Medicaid |
$9.27
|
| Rate for Payer: PHP Medicare Advantage |
$16.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$16.94
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$16.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.05
|
| Rate for Payer: UHC Medicare Advantage |
$17.45
|
| Rate for Payer: VA VA |
$16.94
|
|
|
HC T3 FREE
|
Facility
|
IP
|
$129.60
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$90.72 |
| Max. Negotiated Rate |
$129.60 |
| Rate for Payer: Aetna Commercial |
$116.64
|
| Rate for Payer: ASR ASR |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$100.48
|
| Rate for Payer: BCN Commercial |
$100.48
|
| Rate for Payer: Cash Price |
$103.68
|
| Rate for Payer: Cofinity Commercial |
$121.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.68
|
| Rate for Payer: Healthscope Commercial |
$129.60
|
| Rate for Payer: Healthscope Whirlpool |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$116.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.05
|
|
|
HC T3 REVERSE
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: ASR ASR |
$55.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$44.19
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$53.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$57.00
|
| Rate for Payer: Healthscope Whirlpool |
$55.29
|
| Rate for Payer: Mclaren Commercial |
$51.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.16
|
|
|
HC T3 REVERSE
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare |
$15.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.70
|
| Rate for Payer: ASR ASR |
$55.29
|
| Rate for Payer: BCBS Complete |
$9.05
|
| Rate for Payer: BCBS MAPPO |
$15.76
|
| Rate for Payer: BCBS Trust/PPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$44.19
|
| Rate for Payer: BCN Medicare Advantage |
$15.76
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$53.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.76
|
| Rate for Payer: Healthscope Commercial |
$57.00
|
| Rate for Payer: Healthscope Whirlpool |
$55.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.76
|
| Rate for Payer: Mclaren Commercial |
$51.30
|
| Rate for Payer: Mclaren Medicaid |
$8.62
|
| Rate for Payer: Mclaren Medicare |
$15.76
|
| Rate for Payer: Meridian Medicaid |
$9.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Medicare |
$14.97
|
| Rate for Payer: PACE SWMI |
$15.76
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicaid |
$8.62
|
| Rate for Payer: PHP Medicare Advantage |
$15.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.87
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow Network |
$40.47
|
| Rate for Payer: Railroad Medicare Medicare |
$15.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.16
|
| Rate for Payer: UHC Medicare Advantage |
$16.23
|
| Rate for Payer: VA VA |
$15.76
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
|
|
HC T3 UPTAKE
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$129.98
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$103.89
|
| Rate for Payer: BCN Commercial |
$103.89
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$125.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$134.00
|
| Rate for Payer: Healthscope Whirlpool |
$129.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$120.60
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.73
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$22.98
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.92
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC T4 TOTAL
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Aetna Medicare |
$6.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.59
|
| Rate for Payer: ASR ASR |
$44.62
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$6.87
|
| Rate for Payer: BCBS Trust/PPO |
$35.66
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: BCN Medicare Advantage |
$6.87
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.87
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Whirlpool |
$44.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.87
|
| Rate for Payer: Mclaren Commercial |
$41.40
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| Rate for Payer: Mclaren Medicare |
$6.87
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.10
|
| Rate for Payer: PACE Medicare |
$6.53
|
| Rate for Payer: PACE SWMI |
$6.87
|
| Rate for Payer: PHP Commercial |
$7.56
|
| Rate for Payer: PHP Medicaid |
$3.76
|
| Rate for Payer: PHP Medicare Advantage |
$6.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.76
|
| Rate for Payer: Priority Health Medicare |
$6.87
|
| Rate for Payer: Priority Health Narrow Network |
$23.81
|
| Rate for Payer: Railroad Medicare Medicare |
$6.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.48
|
| Rate for Payer: UHC Medicare Advantage |
$7.08
|
| Rate for Payer: VA VA |
$6.87
|
|
|
HC T4 TOTAL
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: ASR ASR |
$44.62
|
| Rate for Payer: BCBS Trust/PPO |
$35.66
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Whirlpool |
$44.62
|
| Rate for Payer: Mclaren Commercial |
$41.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.48
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
OP
|
$64.26
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$138.53 |
| Rate for Payer: Aetna Commercial |
$57.83
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: ASR ASR |
$62.33
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$49.82
|
| Rate for Payer: BCN Commercial |
$49.82
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$60.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Healthscope Whirlpool |
$62.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.73
|
| Rate for Payer: Mclaren Commercial |
$57.83
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: PHP Medicaid |
$7.51
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.53
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$110.82
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.55
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: VA VA |
$13.73
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
IP
|
$64.26
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.98 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$57.83
|
| Rate for Payer: ASR ASR |
$62.33
|
| Rate for Payer: BCBS Trust/PPO |
$49.82
|
| Rate for Payer: BCN Commercial |
$49.82
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$60.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Healthscope Whirlpool |
$62.33
|
| Rate for Payer: Mclaren Commercial |
$57.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.55
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.58 |
| Max. Negotiated Rate |
$57.97 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: ASR ASR |
$56.23
|
| Rate for Payer: BCBS Trust/PPO |
$44.94
|
| Rate for Payer: BCN Commercial |
$44.94
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$54.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$57.97
|
| Rate for Payer: Healthscope Whirlpool |
$56.23
|
| Rate for Payer: Mclaren Commercial |
$52.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.01
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$294.52 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: ASR ASR |
$56.23
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$44.94
|
| Rate for Payer: BCN Commercial |
$44.94
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$54.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$57.97
|
| Rate for Payer: Healthscope Whirlpool |
$56.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.73
|
| Rate for Payer: Mclaren Commercial |
$52.17
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicaid |
$20.64
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.52
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$235.62
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.01
|
| Rate for Payer: UHC Medicare Advantage |
$38.86
|
| Rate for Payer: VA VA |
$37.73
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
OP
|
$72.20
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$294.52 |
| Rate for Payer: Aetna Commercial |
$64.98
|
| Rate for Payer: Aetna Medicare |
$46.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.72
|
| Rate for Payer: ASR ASR |
$70.03
|
| Rate for Payer: BCBS Complete |
$26.99
|
| Rate for Payer: BCBS MAPPO |
$46.98
|
| Rate for Payer: BCBS Trust/PPO |
$55.98
|
| Rate for Payer: BCN Commercial |
$55.98
|
| Rate for Payer: BCN Medicare Advantage |
$46.98
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cofinity Commercial |
$67.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.98
|
| Rate for Payer: Healthscope Commercial |
$72.20
|
| Rate for Payer: Healthscope Whirlpool |
$70.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$46.98
|
| Rate for Payer: Mclaren Commercial |
$64.98
|
| Rate for Payer: Mclaren Medicaid |
$25.70
|
| Rate for Payer: Mclaren Medicare |
$46.98
|
| Rate for Payer: Meridian Medicaid |
$26.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.37
|
| Rate for Payer: PACE Medicare |
$44.63
|
| Rate for Payer: PACE SWMI |
$46.98
|
| Rate for Payer: PHP Commercial |
$51.68
|
| Rate for Payer: PHP Medicaid |
$25.70
|
| Rate for Payer: PHP Medicare Advantage |
$46.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.52
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: Priority Health Narrow Network |
$235.62
|
| Rate for Payer: Railroad Medicare Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.54
|
| Rate for Payer: UHC Medicare Advantage |
$48.39
|
| Rate for Payer: VA VA |
$46.98
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
IP
|
$72.20
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.54 |
| Max. Negotiated Rate |
$72.20 |
| Rate for Payer: Aetna Commercial |
$64.98
|
| Rate for Payer: ASR ASR |
$70.03
|
| Rate for Payer: BCBS Trust/PPO |
$55.98
|
| Rate for Payer: BCN Commercial |
$55.98
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cofinity Commercial |
$67.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.76
|
| Rate for Payer: Healthscope Commercial |
$72.20
|
| Rate for Payer: Healthscope Whirlpool |
$70.03
|
| Rate for Payer: Mclaren Commercial |
$64.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.54
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$57.97 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: ASR ASR |
$56.23
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$44.94
|
| Rate for Payer: BCN Commercial |
$44.94
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$54.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$57.97
|
| Rate for Payer: Healthscope Whirlpool |
$56.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.73
|
| Rate for Payer: Mclaren Commercial |
$52.17
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicaid |
$20.64
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.75
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$41.16
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.01
|
| Rate for Payer: UHC Medicare Advantage |
$38.86
|
| Rate for Payer: VA VA |
$37.73
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.58 |
| Max. Negotiated Rate |
$57.97 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: ASR ASR |
$56.23
|
| Rate for Payer: BCBS Trust/PPO |
$44.94
|
| Rate for Payer: BCN Commercial |
$44.94
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$54.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$57.97
|
| Rate for Payer: Healthscope Whirlpool |
$56.23
|
| Rate for Payer: Mclaren Commercial |
$52.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.01
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$57.97 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: ASR ASR |
$56.23
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$44.94
|
| Rate for Payer: BCN Commercial |
$44.94
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$54.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$57.97
|
| Rate for Payer: Healthscope Whirlpool |
$56.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.73
|
| Rate for Payer: Mclaren Commercial |
$52.17
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicaid |
$20.64
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.75
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$41.16
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.01
|
| Rate for Payer: UHC Medicare Advantage |
$38.86
|
| Rate for Payer: VA VA |
$37.73
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.58 |
| Max. Negotiated Rate |
$57.97 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: ASR ASR |
$56.23
|
| Rate for Payer: BCBS Trust/PPO |
$44.94
|
| Rate for Payer: BCN Commercial |
$44.94
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$54.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$57.97
|
| Rate for Payer: Healthscope Whirlpool |
$56.23
|
| Rate for Payer: Mclaren Commercial |
$52.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.01
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$81.91
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$81.91 |
| Rate for Payer: Aetna Commercial |
$73.72
|
| Rate for Payer: ASR ASR |
$79.45
|
| Rate for Payer: BCBS Complete |
$32.76
|
| Rate for Payer: BCBS Trust/PPO |
$63.50
|
| Rate for Payer: BCN Commercial |
$63.50
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.53
|
| Rate for Payer: Healthscope Commercial |
$81.91
|
| Rate for Payer: Healthscope Whirlpool |
$79.45
|
| Rate for Payer: Mclaren Commercial |
$73.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.54
|
| Rate for Payer: Priority Health Narrow Network |
$58.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.08
|
|
