|
HC PHARMA AGENT CHALLENGE
|
Facility
|
IP
|
$3,956.14
|
|
|
Service Code
|
CPT 93463
|
| Hospital Charge Code |
48100022
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,967.11 |
| Max. Negotiated Rate |
$3,956.14 |
| Rate for Payer: Aetna Commercial |
$3,560.53
|
| Rate for Payer: ASR ASR |
$3,837.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,248.78
|
| Rate for Payer: BCN Commercial |
$3,248.78
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Commercial |
$3,718.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Healthscope Commercial |
$3,837.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,956.14
|
| Rate for Payer: Mclaren Commercial |
$3,560.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$3,244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,481.40
|
|
|
HC PHARYNX AND OR CERVICAL ESOPHAGUS
|
Facility
|
OP
|
$282.36
|
|
|
Service Code
|
CPT 74210
|
| Hospital Charge Code |
32000295
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$282.36 |
| Rate for Payer: Aetna Commercial |
$254.12
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$273.89
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$232.81
|
| Rate for Payer: BCN Commercial |
$232.81
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$225.89
|
| Rate for Payer: Cash Price |
$225.89
|
| Rate for Payer: Cofinity Commercial |
$265.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$273.89
|
| Rate for Payer: Healthscope Whirlpool |
$282.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$254.12
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.01
|
| Rate for Payer: Nomi Health Commercial |
$231.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.77
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$247.40
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$197.93
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC PHARYNX AND OR CERVICAL ESOPHAGUS
|
Facility
|
IP
|
$282.36
|
|
|
Service Code
|
CPT 74210
|
| Hospital Charge Code |
32000295
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.77 |
| Max. Negotiated Rate |
$282.36 |
| Rate for Payer: Aetna Commercial |
$254.12
|
| Rate for Payer: ASR ASR |
$273.89
|
| Rate for Payer: BCBS Trust/PPO |
$231.87
|
| Rate for Payer: BCN Commercial |
$231.87
|
| Rate for Payer: Cash Price |
$225.89
|
| Rate for Payer: Cofinity Commercial |
$265.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.89
|
| Rate for Payer: Healthscope Commercial |
$273.89
|
| Rate for Payer: Healthscope Whirlpool |
$282.36
|
| Rate for Payer: Mclaren Commercial |
$254.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.01
|
| Rate for Payer: Nomi Health Commercial |
$231.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.48
|
|
|
HC PHASE III REHAB FULL MONTH
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
99000048
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: ASR ASR |
$48.50
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$41.23
|
| Rate for Payer: BCN Commercial |
$41.23
|
| 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 |
$48.50
|
| Rate for Payer: Healthscope Whirlpool |
$50.00
|
| Rate for Payer: Mclaren Commercial |
$45.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.50
|
| Rate for Payer: Nomi Health Commercial |
$41.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.81
|
| Rate for Payer: Priority Health Narrow Network |
$35.05
|
|
|
HC PHASE III REHAB FULL MONTH
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
99000048
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$37.50 |
| 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 |
$41.06
|
| Rate for Payer: BCN Commercial |
$41.06
|
| 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 |
$48.50
|
| Rate for Payer: Healthscope Whirlpool |
$50.00
|
| Rate for Payer: Mclaren Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.50
|
| Rate for Payer: Nomi Health Commercial |
$41.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
|
|
HC PHASE III REHAB PARTIAL MONTH
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
99000049
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: ASR ASR |
$24.25
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS Trust/PPO |
$20.61
|
| Rate for Payer: BCN Commercial |
$20.61
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$23.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$24.25
|
| Rate for Payer: Healthscope Whirlpool |
$25.00
|
| Rate for Payer: Mclaren Commercial |
$22.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.91
|
| Rate for Payer: Priority Health Narrow Network |
$17.52
|
|
|
HC PHASE III REHAB PARTIAL MONTH
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
99000049
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: ASR ASR |
$24.25
|
| Rate for Payer: BCBS Trust/PPO |
$20.53
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$23.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$24.25
|
| Rate for Payer: Healthscope Whirlpool |
$25.00
|
| Rate for Payer: Mclaren Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
|
|
HC PH BLOOD
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
30100215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.06 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: BCBS Trust/PPO |
$58.10
|
| Rate for Payer: BCN Commercial |
$58.10
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$68.63
|
| Rate for Payer: Healthscope Whirlpool |
$70.75
|
| Rate for Payer: Mclaren Commercial |
$63.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
|
|
HC PH BLOOD
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
30100215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$102.29 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.75
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$11.00
|
| Rate for Payer: BCBS Trust/PPO |
$58.33
|
| Rate for Payer: BCN Commercial |
$58.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.00
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.00
|
| Rate for Payer: Healthscope Commercial |
$68.63
|
| Rate for Payer: Healthscope Whirlpool |
$70.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.00
|
| Rate for Payer: Mclaren Commercial |
$63.67
|
| Rate for Payer: Mclaren Medicaid |
$11.00
|
| Rate for Payer: Mclaren Medicare |
$11.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.55
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Medicare |
$10.45
|
| Rate for Payer: PACE SWMI |
$11.00
|
| Rate for Payer: PHP Commercial |
$12.10
|
| Rate for Payer: PHP Medicaid |
$5.90
|
| Rate for Payer: PHP Medicare Advantage |
$11.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.29
|
| Rate for Payer: Priority Health Medicare |
$11.00
|
| Rate for Payer: Priority Health Narrow Network |
$81.83
|
| Rate for Payer: Railroad Medicare Medicare |
$11.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.00
|
| Rate for Payer: UHC Exchange |
$17.05
|
| Rate for Payer: UHC Medicaid |
$5.75
|
| Rate for Payer: UHCCP DNSP |
$11.00
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: VA VA |
$11.00
|
|
|
HC PH BODY FLUID
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$25.67 |
| Rate for Payer: Aetna Commercial |
$23.10
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.47
|
| Rate for Payer: ASR ASR |
$24.90
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$21.16
|
| Rate for Payer: BCN Commercial |
$21.16
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$24.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$24.90
|
| Rate for Payer: Healthscope Whirlpool |
$25.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.58
|
| Rate for Payer: Mclaren Commercial |
$23.10
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$3.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: Meridian Medicaid |
$1.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.82
|
| Rate for Payer: Nomi Health Commercial |
$21.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: PACE Medicare |
$3.40
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: PHP Medicaid |
$1.92
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: Priority Health Narrow Network |
$12.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.58
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicaid |
$1.87
|
| Rate for Payer: UHCCP DNSP |
$3.58
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
| Rate for Payer: VA VA |
$3.58
|
|
|
HC PH BODY FLUID
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$25.67 |
| Rate for Payer: Aetna Commercial |
$23.10
|
| Rate for Payer: ASR ASR |
$24.90
|
| Rate for Payer: BCBS Trust/PPO |
$21.08
|
| Rate for Payer: BCN Commercial |
$21.08
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$24.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Healthscope Commercial |
$24.90
|
| Rate for Payer: Healthscope Whirlpool |
$25.67
|
| Rate for Payer: Mclaren Commercial |
$23.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.82
|
| Rate for Payer: Nomi Health Commercial |
$21.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.59
|
|
|
HC PHENOBARB LVL
|
Facility
|
IP
|
$102.58
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.94 |
| Max. Negotiated Rate |
$102.58 |
| Rate for Payer: Aetna Commercial |
$92.32
|
| Rate for Payer: ASR ASR |
$99.50
|
| Rate for Payer: BCBS Trust/PPO |
$84.24
|
| Rate for Payer: BCN Commercial |
$84.24
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cofinity Commercial |
$96.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$99.50
|
| Rate for Payer: Healthscope Whirlpool |
$102.58
|
| Rate for Payer: Mclaren Commercial |
$92.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.19
|
| Rate for Payer: Nomi Health Commercial |
$84.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.27
|
|
|
HC PHENOBARB LVL
|
Facility
|
OP
|
$102.58
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$102.58 |
| Rate for Payer: Aetna Commercial |
$92.32
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: ASR ASR |
$99.50
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$84.58
|
| Rate for Payer: BCN Commercial |
$84.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cofinity Commercial |
$96.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$99.50
|
| Rate for Payer: Healthscope Whirlpool |
$102.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$92.32
|
| Rate for Payer: Mclaren Medicaid |
$15.30
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.19
|
| Rate for Payer: Nomi Health Commercial |
$84.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.94
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicaid |
$8.20
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.83
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$75.06
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.30
|
| Rate for Payer: UHC Exchange |
$23.71
|
| Rate for Payer: UHC Medicaid |
$8.00
|
| Rate for Payer: UHCCP DNSP |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$8.00
|
| Rate for Payer: VA VA |
$15.30
|
|
|
HC PH GASTRIC
|
Facility
|
IP
|
$25.17
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.88 |
| Max. Negotiated Rate |
$25.17 |
| Rate for Payer: Aetna Commercial |
$22.65
|
| Rate for Payer: ASR ASR |
$24.41
|
| Rate for Payer: BCBS Trust/PPO |
$20.67
|
| Rate for Payer: BCN Commercial |
$20.67
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$23.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$24.41
|
| Rate for Payer: Healthscope Whirlpool |
$25.17
|
| Rate for Payer: Mclaren Commercial |
$22.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$20.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.15
|
|
|
HC PH GASTRIC
|
Facility
|
OP
|
$25.17
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$25.17 |
| Rate for Payer: Aetna Commercial |
$22.65
|
| Rate for Payer: Aetna Medicare |
$6.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.39
|
| Rate for Payer: ASR ASR |
$24.41
|
| Rate for Payer: BCBS Complete |
$3.69
|
| Rate for Payer: BCBS MAPPO |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$20.75
|
| Rate for Payer: BCN Commercial |
$20.75
|
| Rate for Payer: BCN Medicare Advantage |
$6.71
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$23.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.71
|
| Rate for Payer: Healthscope Commercial |
$24.41
|
| Rate for Payer: Healthscope Whirlpool |
$25.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.71
|
| Rate for Payer: Mclaren Commercial |
$22.65
|
| Rate for Payer: Mclaren Medicaid |
$6.71
|
| Rate for Payer: Mclaren Medicare |
$6.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.05
|
| Rate for Payer: Meridian Medicaid |
$3.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$20.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.88
|
| Rate for Payer: PACE Medicare |
$6.37
|
| Rate for Payer: PACE SWMI |
$6.71
|
| Rate for Payer: PHP Commercial |
$7.38
|
| Rate for Payer: PHP Medicaid |
$3.60
|
| Rate for Payer: PHP Medicare Advantage |
$6.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.05
|
| Rate for Payer: Priority Health Medicare |
$6.71
|
| Rate for Payer: Priority Health Narrow Network |
$17.64
|
| Rate for Payer: Railroad Medicare Medicare |
$6.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.71
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicaid |
$3.51
|
| Rate for Payer: UHCCP DNSP |
$6.71
|
| Rate for Payer: UHCCP Medicaid |
$3.51
|
| Rate for Payer: VA VA |
$6.71
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.57 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$36.57
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: BCBS Complete |
$39.54
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$81.49
|
| 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 |
$95.87
|
| Rate for Payer: Healthscope Whirlpool |
$98.84
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.13 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$81.17
|
| Rate for Payer: BCN Commercial |
$81.17
|
| 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 |
$95.87
|
| Rate for Payer: Healthscope Whirlpool |
$98.84
|
| 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: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
OP
|
$76.99
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$76.99 |
| Rate for Payer: Aetna Commercial |
$69.29
|
| Rate for Payer: Aetna Medicare |
$16.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.65
|
| Rate for Payer: ASR ASR |
$74.68
|
| Rate for Payer: BCBS Complete |
$9.07
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$63.48
|
| Rate for Payer: BCN Commercial |
$63.48
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$74.68
|
| Rate for Payer: Healthscope Whirlpool |
$76.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.52
|
| Rate for Payer: Mclaren Commercial |
$69.29
|
| Rate for Payer: Mclaren Medicaid |
$16.52
|
| Rate for Payer: Mclaren Medicare |
$16.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.35
|
| Rate for Payer: Meridian Medicaid |
$9.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$63.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.74
|
| Rate for Payer: PACE Medicare |
$15.69
|
| Rate for Payer: PACE SWMI |
$16.52
|
| Rate for Payer: PHP Commercial |
$18.17
|
| Rate for Payer: PHP Medicaid |
$8.85
|
| Rate for Payer: PHP Medicare Advantage |
$16.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.46
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow Network |
$53.97
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.52
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UHC Medicaid |
$8.64
|
| Rate for Payer: UHCCP DNSP |
$16.52
|
| Rate for Payer: UHCCP Medicaid |
$8.64
|
| Rate for Payer: VA VA |
$16.52
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
IP
|
$76.99
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.74 |
| Max. Negotiated Rate |
$76.99 |
| Rate for Payer: Aetna Commercial |
$69.29
|
| Rate for Payer: ASR ASR |
$74.68
|
| Rate for Payer: BCBS Trust/PPO |
$63.22
|
| Rate for Payer: BCN Commercial |
$63.22
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Healthscope Commercial |
$74.68
|
| Rate for Payer: Healthscope Whirlpool |
$76.99
|
| Rate for Payer: Mclaren Commercial |
$69.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$63.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.75
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.76 |
| Max. Negotiated Rate |
$86.35 |
| Rate for Payer: Aetna Commercial |
$77.72
|
| Rate for Payer: ASR ASR |
$83.76
|
| Rate for Payer: BCBS Trust/PPO |
$70.91
|
| Rate for Payer: BCN Commercial |
$70.91
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$81.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$86.35
|
| Rate for Payer: Mclaren Commercial |
$77.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.99
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$86.35 |
| Rate for Payer: Aetna Commercial |
$77.72
|
| Rate for Payer: Aetna Medicare |
$16.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.65
|
| Rate for Payer: ASR ASR |
$83.76
|
| Rate for Payer: BCBS Complete |
$9.07
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$71.20
|
| Rate for Payer: BCN Commercial |
$71.20
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$81.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$86.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.52
|
| Rate for Payer: Mclaren Commercial |
$77.72
|
| Rate for Payer: Mclaren Medicaid |
$16.52
|
| Rate for Payer: Mclaren Medicare |
$16.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.35
|
| Rate for Payer: Meridian Medicaid |
$9.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Medicare |
$15.69
|
| Rate for Payer: PACE SWMI |
$16.52
|
| Rate for Payer: PHP Commercial |
$18.17
|
| Rate for Payer: PHP Medicaid |
$8.85
|
| Rate for Payer: PHP Medicare Advantage |
$16.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$75.66
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow Network |
$60.53
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.52
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UHC Medicaid |
$8.64
|
| Rate for Payer: UHCCP DNSP |
$16.52
|
| Rate for Payer: UHCCP Medicaid |
$8.64
|
| Rate for Payer: VA VA |
$16.52
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
OP
|
$56.24
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$56.24 |
| Rate for Payer: Aetna Commercial |
$50.62
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$54.55
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$46.37
|
| Rate for Payer: BCN Commercial |
$46.37
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$52.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$56.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$50.62
|
| Rate for Payer: Mclaren Medicaid |
$16.07
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.28
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$39.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
IP
|
$56.24
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.18 |
| Max. Negotiated Rate |
$56.24 |
| Rate for Payer: Aetna Commercial |
$50.62
|
| Rate for Payer: ASR ASR |
$54.55
|
| Rate for Payer: BCBS Trust/PPO |
$46.18
|
| Rate for Payer: BCN Commercial |
$46.18
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$52.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$56.24
|
| Rate for Payer: Mclaren Commercial |
$50.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.49
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$55.18 |
| Rate for Payer: Aetna Commercial |
$49.66
|
| Rate for Payer: ASR ASR |
$53.52
|
| Rate for Payer: BCBS Trust/PPO |
$45.31
|
| Rate for Payer: BCN Commercial |
$45.31
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$51.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$53.52
|
| Rate for Payer: Healthscope Whirlpool |
$55.18
|
| Rate for Payer: Mclaren Commercial |
$49.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.56
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$55.18 |
| Rate for Payer: Aetna Commercial |
$49.66
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$53.52
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$45.50
|
| Rate for Payer: BCN Commercial |
$45.50
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$51.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$53.52
|
| Rate for Payer: Healthscope Whirlpool |
$55.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$49.66
|
| Rate for Payer: Mclaren Medicaid |
$16.07
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.35
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$38.68
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: VA VA |
$16.07
|
|
