|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$19.71 |
| Max. Negotiated Rate |
$65.38 |
| Rate for Payer: Aetna Commercial |
$47.95
|
| Rate for Payer: Aetna Medicare |
$19.71
|
| Rate for Payer: ASR ASR |
$51.68
|
| Rate for Payer: BCBS Complete |
$21.31
|
| Rate for Payer: BCBS Trust/PPO |
$43.93
|
| Rate for Payer: BCN Commercial |
$43.93
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$51.68
|
| Rate for Payer: Healthscope Whirlpool |
$53.28
|
| Rate for Payer: Mclaren Commercial |
$47.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.89
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$117.88
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$117.88 |
| Rate for Payer: Aetna Commercial |
$106.09
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: ASR ASR |
$114.34
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$97.19
|
| Rate for Payer: BCN Commercial |
$97.19
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cofinity Commercial |
$110.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$114.34
|
| Rate for Payer: Healthscope Whirlpool |
$117.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.92
|
| Rate for Payer: Mclaren Commercial |
$106.09
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$28.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$96.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.41
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicaid |
$27.83
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.29
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.48
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$51.92
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$117.88
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$117.88 |
| Rate for Payer: Aetna Commercial |
$106.09
|
| Rate for Payer: ASR ASR |
$114.34
|
| Rate for Payer: BCBS Trust/PPO |
$96.80
|
| Rate for Payer: BCN Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cofinity Commercial |
$110.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.30
|
| Rate for Payer: Healthscope Commercial |
$114.34
|
| Rate for Payer: Healthscope Whirlpool |
$117.88
|
| Rate for Payer: Mclaren Commercial |
$106.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$96.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.73
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$122.49 |
| Max. Negotiated Rate |
$163.32 |
| Rate for Payer: Aetna Commercial |
$146.99
|
| Rate for Payer: ASR ASR |
$158.42
|
| Rate for Payer: BCBS Trust/PPO |
$134.12
|
| Rate for Payer: BCN Commercial |
$134.12
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Commercial |
$153.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Healthscope Commercial |
$158.42
|
| Rate for Payer: Healthscope Whirlpool |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$146.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Nomi Health Commercial |
$133.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.72
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$199.62 |
| Rate for Payer: Aetna Commercial |
$146.99
|
| Rate for Payer: Aetna Medicare |
$128.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.99
|
| Rate for Payer: ASR ASR |
$158.42
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$128.79
|
| Rate for Payer: BCBS Trust/PPO |
$134.66
|
| Rate for Payer: BCN Commercial |
$134.66
|
| Rate for Payer: BCN Medicare Advantage |
$128.79
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Commercial |
$153.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.79
|
| Rate for Payer: Healthscope Commercial |
$158.42
|
| Rate for Payer: Healthscope Whirlpool |
$163.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.79
|
| Rate for Payer: Mclaren Commercial |
$146.99
|
| Rate for Payer: Mclaren Medicaid |
$128.79
|
| Rate for Payer: Mclaren Medicare |
$128.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.23
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Nomi Health Commercial |
$133.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PACE Medicare |
$122.35
|
| Rate for Payer: PACE SWMI |
$128.79
|
| Rate for Payer: PHP Commercial |
$141.67
|
| Rate for Payer: PHP Medicaid |
$69.03
|
| Rate for Payer: PHP Medicare Advantage |
$128.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.10
|
| Rate for Payer: Priority Health Medicare |
$128.79
|
| Rate for Payer: Priority Health Narrow Network |
$114.49
|
| Rate for Payer: Railroad Medicare Medicare |
$128.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.79
|
| Rate for Payer: UHC Exchange |
$199.62
|
| Rate for Payer: UHC Medicaid |
$67.36
|
| Rate for Payer: UHCCP DNSP |
$128.79
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: VA VA |
$128.79
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$66.06 |
| Max. Negotiated Rate |
$88.08 |
| Rate for Payer: Aetna Commercial |
$79.27
|
| Rate for Payer: ASR ASR |
$85.44
|
| Rate for Payer: BCBS Trust/PPO |
$72.33
|
| Rate for Payer: BCN Commercial |
$72.33
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Commercial |
$82.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Healthscope Commercial |
$85.44
|
| Rate for Payer: Healthscope Whirlpool |
$88.08
|
| Rate for Payer: Mclaren Commercial |
$79.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$72.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.51
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$88.08 |
| Rate for Payer: Aetna Commercial |
$79.27
|
| Rate for Payer: Aetna Medicare |
$6.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: ASR ASR |
$85.44
|
| Rate for Payer: BCBS Complete |
$3.59
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$72.62
|
| Rate for Payer: BCN Commercial |
$72.62
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Commercial |
$82.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$85.44
|
| Rate for Payer: Healthscope Whirlpool |
$88.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.53
|
| Rate for Payer: Mclaren Commercial |
$79.27
|
| Rate for Payer: Mclaren Medicaid |
$6.53
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: Meridian Medicaid |
$3.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$72.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$7.18
|
| Rate for Payer: PHP Medicaid |
$3.50
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$77.18
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health Narrow Network |
$61.74
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.53
|
| Rate for Payer: UHC Exchange |
$10.12
|
| Rate for Payer: UHC Medicaid |
$3.42
|
| Rate for Payer: UHCCP DNSP |
$6.53
|
| Rate for Payer: UHCCP Medicaid |
$3.42
|
| Rate for Payer: VA VA |
$6.53
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$74.42 |
| Max. Negotiated Rate |
$99.23 |
| Rate for Payer: Aetna Commercial |
$89.31
|
| Rate for Payer: ASR ASR |
$96.25
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$81.49
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$93.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Healthscope Commercial |
$96.25
|
| Rate for Payer: Healthscope Whirlpool |
$99.23
|
| Rate for Payer: Mclaren Commercial |
$89.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.32
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$99.23 |
| Rate for Payer: Aetna Commercial |
$89.31
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: ASR ASR |
$96.25
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$81.82
|
| Rate for Payer: BCN Commercial |
$81.82
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$93.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$96.25
|
| Rate for Payer: Healthscope Whirlpool |
$99.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.91
|
| Rate for Payer: Mclaren Commercial |
$89.31
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicaid |
$13.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.95
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$69.56
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$38.61
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP DNSP |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$276.60 |
| Rate for Payer: Aetna Commercial |
$91.69
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$98.82
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$84.00
|
| Rate for Payer: BCN Commercial |
$84.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Commercial |
$95.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$98.82
|
| Rate for Payer: Healthscope Whirlpool |
$101.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$91.69
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Nomi Health Commercial |
$83.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$9.85
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.60
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$221.28
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$28.47
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP DNSP |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$76.41 |
| Max. Negotiated Rate |
$101.88 |
| Rate for Payer: Aetna Commercial |
$91.69
|
| Rate for Payer: ASR ASR |
$98.82
|
| Rate for Payer: BCBS Trust/PPO |
$83.66
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Commercial |
$95.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Healthscope Commercial |
$98.82
|
| Rate for Payer: Healthscope Whirlpool |
$101.88
|
| Rate for Payer: Mclaren Commercial |
$91.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Nomi Health Commercial |
$83.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.65
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$284.72
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$73.58 |
| Max. Negotiated Rate |
$284.72 |
| Rate for Payer: Aetna Commercial |
$256.25
|
| Rate for Payer: Aetna Medicare |
$140.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.86
|
| Rate for Payer: ASR ASR |
$276.18
|
| Rate for Payer: BCBS Complete |
$77.27
|
| Rate for Payer: BCBS MAPPO |
$140.69
|
| Rate for Payer: BCBS Trust/PPO |
$234.75
|
| Rate for Payer: BCN Commercial |
$234.75
|
| Rate for Payer: BCN Medicare Advantage |
$140.69
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cofinity Commercial |
$267.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.69
|
| Rate for Payer: Healthscope Commercial |
$276.18
|
| Rate for Payer: Healthscope Whirlpool |
$284.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.69
|
| Rate for Payer: Mclaren Commercial |
$256.25
|
| Rate for Payer: Mclaren Medicaid |
$140.69
|
| Rate for Payer: Mclaren Medicare |
$140.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.72
|
| Rate for Payer: Meridian Medicaid |
$77.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.01
|
| Rate for Payer: Nomi Health Commercial |
$233.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.54
|
| Rate for Payer: PACE Medicare |
$133.66
|
| Rate for Payer: PACE SWMI |
$140.69
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: PHP Medicaid |
$75.41
|
| Rate for Payer: PHP Medicare Advantage |
$140.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$270.35
|
| Rate for Payer: Priority Health Medicare |
$140.69
|
| Rate for Payer: Priority Health Narrow Network |
$216.28
|
| Rate for Payer: Railroad Medicare Medicare |
$140.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.69
|
| Rate for Payer: UHC Exchange |
$218.07
|
| Rate for Payer: UHC Medicaid |
$73.58
|
| Rate for Payer: UHCCP DNSP |
$140.69
|
| Rate for Payer: UHCCP Medicaid |
$73.58
|
| Rate for Payer: VA VA |
$140.69
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$284.72
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$213.54 |
| Max. Negotiated Rate |
$284.72 |
| Rate for Payer: Aetna Commercial |
$256.25
|
| Rate for Payer: ASR ASR |
$276.18
|
| Rate for Payer: BCBS Trust/PPO |
$233.81
|
| Rate for Payer: BCN Commercial |
$233.81
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cofinity Commercial |
$267.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.78
|
| Rate for Payer: Healthscope Commercial |
$276.18
|
| Rate for Payer: Healthscope Whirlpool |
$284.72
|
| Rate for Payer: Mclaren Commercial |
$256.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.01
|
| Rate for Payer: Nomi Health Commercial |
$233.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.55
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$39.43 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: ASR ASR |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$32.38
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$38.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.43
|
| Rate for Payer: Mclaren Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.70
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$39.43 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: Aetna Medicare |
$4.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.60
|
| Rate for Payer: ASR ASR |
$38.25
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS MAPPO |
$4.48
|
| Rate for Payer: BCBS Trust/PPO |
$32.51
|
| Rate for Payer: BCN Commercial |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$4.48
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$38.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.48
|
| Rate for Payer: Mclaren Commercial |
$35.49
|
| Rate for Payer: Mclaren Medicaid |
$4.48
|
| Rate for Payer: Mclaren Medicare |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.70
|
| Rate for Payer: Meridian Medicaid |
$2.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$4.26
|
| Rate for Payer: PACE SWMI |
$4.48
|
| Rate for Payer: PHP Commercial |
$4.93
|
| Rate for Payer: PHP Medicaid |
$2.40
|
| Rate for Payer: PHP Medicare Advantage |
$4.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34.55
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health Narrow Network |
$27.64
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.48
|
| Rate for Payer: UHC Exchange |
$6.94
|
| Rate for Payer: UHC Medicaid |
$2.34
|
| Rate for Payer: UHCCP DNSP |
$4.48
|
| Rate for Payer: UHCCP Medicaid |
$2.34
|
| Rate for Payer: VA VA |
$4.48
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$126.49
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$94.87 |
| Max. Negotiated Rate |
$126.49 |
| Rate for Payer: Aetna Commercial |
$113.84
|
| Rate for Payer: ASR ASR |
$122.70
|
| Rate for Payer: BCBS Trust/PPO |
$103.87
|
| Rate for Payer: BCN Commercial |
$103.87
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Commercial |
$118.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Healthscope Commercial |
$122.70
|
| Rate for Payer: Healthscope Whirlpool |
$126.49
|
| Rate for Payer: Mclaren Commercial |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.52
|
| Rate for Payer: Nomi Health Commercial |
$103.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.31
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$126.49
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$126.49 |
| Rate for Payer: Aetna Commercial |
$113.84
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: ASR ASR |
$122.70
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$104.29
|
| Rate for Payer: BCN Commercial |
$104.29
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Commercial |
$118.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$122.70
|
| Rate for Payer: Healthscope Whirlpool |
$126.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.91
|
| Rate for Payer: Mclaren Commercial |
$113.84
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.52
|
| Rate for Payer: Nomi Health Commercial |
$103.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.87
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicaid |
$13.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$88.67
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$38.61
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP DNSP |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$410.58
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$410.58 |
| Rate for Payer: Aetna Commercial |
$369.52
|
| Rate for Payer: Aetna Medicare |
$184.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.12
|
| Rate for Payer: ASR ASR |
$398.26
|
| Rate for Payer: BCBS Complete |
$101.55
|
| Rate for Payer: BCBS MAPPO |
$184.90
|
| Rate for Payer: BCBS Trust/PPO |
$338.52
|
| Rate for Payer: BCN Commercial |
$338.52
|
| Rate for Payer: BCN Medicare Advantage |
$184.90
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cofinity Commercial |
$385.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.90
|
| Rate for Payer: Healthscope Commercial |
$398.26
|
| Rate for Payer: Healthscope Whirlpool |
$410.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$184.90
|
| Rate for Payer: Mclaren Commercial |
$369.52
|
| Rate for Payer: Mclaren Medicaid |
$184.90
|
| Rate for Payer: Mclaren Medicare |
$184.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.15
|
| Rate for Payer: Meridian Medicaid |
$101.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.99
|
| Rate for Payer: Nomi Health Commercial |
$336.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.94
|
| Rate for Payer: PACE Medicare |
$175.66
|
| Rate for Payer: PACE SWMI |
$184.90
|
| Rate for Payer: PHP Commercial |
$203.39
|
| Rate for Payer: PHP Medicaid |
$99.11
|
| Rate for Payer: PHP Medicare Advantage |
$184.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$359.75
|
| Rate for Payer: Priority Health Medicare |
$184.90
|
| Rate for Payer: Priority Health Narrow Network |
$287.82
|
| Rate for Payer: Railroad Medicare Medicare |
$184.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$361.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$184.90
|
| Rate for Payer: UHC Exchange |
$286.60
|
| Rate for Payer: UHC Medicaid |
$96.70
|
| Rate for Payer: UHCCP DNSP |
$184.90
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
| Rate for Payer: VA VA |
$184.90
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$410.58
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$307.94 |
| Max. Negotiated Rate |
$410.58 |
| Rate for Payer: Aetna Commercial |
$369.52
|
| Rate for Payer: ASR ASR |
$398.26
|
| Rate for Payer: BCBS Trust/PPO |
$337.17
|
| Rate for Payer: BCN Commercial |
$337.17
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cofinity Commercial |
$385.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.46
|
| Rate for Payer: Healthscope Commercial |
$398.26
|
| Rate for Payer: Healthscope Whirlpool |
$410.58
|
| Rate for Payer: Mclaren Commercial |
$369.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.99
|
| Rate for Payer: Nomi Health Commercial |
$336.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$361.31
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$74.42 |
| Max. Negotiated Rate |
$99.23 |
| Rate for Payer: Aetna Commercial |
$89.31
|
| Rate for Payer: ASR ASR |
$96.25
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$81.49
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$93.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Healthscope Commercial |
$96.25
|
| Rate for Payer: Healthscope Whirlpool |
$99.23
|
| Rate for Payer: Mclaren Commercial |
$89.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.32
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$99.23 |
| Rate for Payer: Aetna Commercial |
$89.31
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: ASR ASR |
$96.25
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$81.82
|
| Rate for Payer: BCN Commercial |
$81.82
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$93.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$96.25
|
| Rate for Payer: Healthscope Whirlpool |
$99.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.91
|
| Rate for Payer: Mclaren Commercial |
$89.31
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicaid |
$13.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.95
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$69.56
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$38.61
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP DNSP |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
IP
|
$94.45
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$70.84 |
| Max. Negotiated Rate |
$94.45 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: ASR ASR |
$91.62
|
| Rate for Payer: BCBS Trust/PPO |
$77.56
|
| Rate for Payer: BCN Commercial |
$77.56
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Healthscope Commercial |
$91.62
|
| Rate for Payer: Healthscope Whirlpool |
$94.45
|
| Rate for Payer: Mclaren Commercial |
$85.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.12
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
OP
|
$94.45
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$94.45 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$24.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: ASR ASR |
$91.62
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$77.87
|
| Rate for Payer: BCN Commercial |
$77.87
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$91.62
|
| Rate for Payer: Healthscope Whirlpool |
$94.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.91
|
| Rate for Payer: Mclaren Commercial |
$85.00
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicaid |
$13.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82.76
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$66.21
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$38.61
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP DNSP |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: VA VA |
$24.91
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
IP
|
$1,981.28
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,485.96 |
| Max. Negotiated Rate |
$1,981.28 |
| Rate for Payer: Aetna Commercial |
$1,783.15
|
| Rate for Payer: ASR ASR |
$1,921.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,627.03
|
| Rate for Payer: BCN Commercial |
$1,627.03
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cofinity Commercial |
$1,862.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.02
|
| Rate for Payer: Healthscope Commercial |
$1,921.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.28
|
| Rate for Payer: Mclaren Commercial |
$1,783.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.09
|
| Rate for Payer: Nomi Health Commercial |
$1,624.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,743.53
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
OP
|
$1,981.28
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$721.30 |
| Max. Negotiated Rate |
$2,137.68 |
| Rate for Payer: Aetna Commercial |
$1,783.15
|
| Rate for Payer: Aetna Medicare |
$1,379.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,723.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,723.94
|
| Rate for Payer: ASR ASR |
$1,921.84
|
| Rate for Payer: BCBS Complete |
$757.43
|
| Rate for Payer: BCBS MAPPO |
$1,379.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.57
|
| Rate for Payer: BCN Commercial |
$1,633.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.15
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cofinity Commercial |
$1,862.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.15
|
| Rate for Payer: Healthscope Commercial |
$1,921.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,379.15
|
| Rate for Payer: Mclaren Commercial |
$1,783.15
|
| Rate for Payer: Mclaren Medicaid |
$1,379.15
|
| Rate for Payer: Mclaren Medicare |
$1,379.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.11
|
| Rate for Payer: Meridian Medicaid |
$757.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,586.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,517.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.09
|
| Rate for Payer: Nomi Health Commercial |
$1,624.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.96
|
| Rate for Payer: PACE Medicare |
$1,310.19
|
| Rate for Payer: PACE SWMI |
$1,379.15
|
| Rate for Payer: PHP Commercial |
$1,517.07
|
| Rate for Payer: PHP Medicaid |
$739.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,736.00
|
| Rate for Payer: Priority Health Medicare |
$1,379.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,388.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,743.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,379.15
|
| Rate for Payer: UHC Exchange |
$2,137.68
|
| Rate for Payer: UHC Medicaid |
$721.30
|
| Rate for Payer: UHCCP DNSP |
$1,379.15
|
| Rate for Payer: UHCCP Medicaid |
$721.30
|
| Rate for Payer: VA VA |
$1,379.15
|
|
