|
HC PATHOLOGY LEVEL I
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 88300
|
| Hospital Charge Code |
31000045
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$29.21 |
| Max. Negotiated Rate |
$44.94 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: ASR ASR |
$43.59
|
| Rate for Payer: ASR Commercial |
$43.59
|
| Rate for Payer: BCBS Trust/PPO |
$36.62
|
| Rate for Payer: BCN Commercial |
$34.84
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$42.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$44.94
|
| Rate for Payer: Healthscope Whirlpool |
$43.59
|
| Rate for Payer: Mclaren Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.55
|
|
|
HC PATHOLOGY LEVEL II
|
Facility
|
OP
|
$98.52
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
31000046
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$98.52 |
| Rate for Payer: Aetna Commercial |
$88.67
|
| Rate for Payer: Aetna Medicare |
$38.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: ASR ASR |
$95.56
|
| Rate for Payer: ASR Commercial |
$95.56
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$80.68
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cofinity Commercial |
$92.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$98.52
|
| Rate for Payer: Healthscope Whirlpool |
$95.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.28
|
| Rate for Payer: Mclaren Commercial |
$88.67
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.74
|
| Rate for Payer: Nomi Health Commercial |
$80.79
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$42.11
|
| Rate for Payer: PHP Medicaid |
$20.52
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.32
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health Narrow Network |
$69.06
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$59.33
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP DNSP |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: VA VA |
$38.28
|
|
|
HC PATHOLOGY LEVEL II
|
Facility
|
IP
|
$98.52
|
|
|
Service Code
|
CPT 88302
|
| Hospital Charge Code |
31000046
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.04 |
| Max. Negotiated Rate |
$98.52 |
| Rate for Payer: Aetna Commercial |
$88.67
|
| Rate for Payer: ASR ASR |
$95.56
|
| Rate for Payer: ASR Commercial |
$95.56
|
| Rate for Payer: BCBS Trust/PPO |
$80.28
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cofinity Commercial |
$92.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.82
|
| Rate for Payer: Healthscope Commercial |
$98.52
|
| Rate for Payer: Healthscope Whirlpool |
$95.56
|
| Rate for Payer: Mclaren Commercial |
$88.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.74
|
| Rate for Payer: Nomi Health Commercial |
$80.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.70
|
|
|
HC PATHOLOGY LEVEL III
|
Facility
|
IP
|
$149.30
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000047
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$97.05 |
| Max. Negotiated Rate |
$149.30 |
| Rate for Payer: Aetna Commercial |
$134.37
|
| Rate for Payer: ASR ASR |
$144.82
|
| Rate for Payer: ASR Commercial |
$144.82
|
| Rate for Payer: BCBS Trust/PPO |
$121.66
|
| Rate for Payer: BCN Commercial |
$115.75
|
| Rate for Payer: Cash Price |
$119.44
|
| Rate for Payer: Cofinity Commercial |
$140.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.44
|
| Rate for Payer: Healthscope Commercial |
$149.30
|
| Rate for Payer: Healthscope Whirlpool |
$144.82
|
| Rate for Payer: Mclaren Commercial |
$134.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.91
|
| Rate for Payer: Nomi Health Commercial |
$122.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.38
|
|
|
HC PATHOLOGY LEVEL III
|
Facility
|
OP
|
$149.30
|
|
|
Service Code
|
CPT 88304
|
| Hospital Charge Code |
31000047
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$149.30 |
| Rate for Payer: Aetna Commercial |
$134.37
|
| Rate for Payer: Aetna Medicare |
$52.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: ASR ASR |
$144.82
|
| Rate for Payer: ASR Commercial |
$144.82
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$122.26
|
| Rate for Payer: BCN Commercial |
$115.75
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$119.44
|
| Rate for Payer: Cash Price |
$119.44
|
| Rate for Payer: Cofinity Commercial |
$140.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$149.30
|
| Rate for Payer: Healthscope Whirlpool |
$144.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.11
|
| Rate for Payer: Mclaren Commercial |
$134.37
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.91
|
| Rate for Payer: Nomi Health Commercial |
$122.43
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$57.32
|
| Rate for Payer: PHP Medicaid |
$27.93
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.82
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health Narrow Network |
$104.66
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP DNSP |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
OP
|
$209.12
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$209.12 |
| Rate for Payer: Aetna Commercial |
$188.21
|
| Rate for Payer: Aetna Medicare |
$52.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: ASR ASR |
$202.85
|
| Rate for Payer: ASR Commercial |
$202.85
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$171.25
|
| Rate for Payer: BCN Commercial |
$162.13
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$196.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$209.12
|
| Rate for Payer: Healthscope Whirlpool |
$202.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.11
|
| Rate for Payer: Mclaren Commercial |
$188.21
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: Nomi Health Commercial |
$171.48
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$57.32
|
| Rate for Payer: PHP Medicaid |
$27.93
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.23
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health Narrow Network |
$146.59
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP DNSP |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
IP
|
$209.12
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$135.93 |
| Max. Negotiated Rate |
$209.12 |
| Rate for Payer: Aetna Commercial |
$188.21
|
| Rate for Payer: ASR ASR |
$202.85
|
| Rate for Payer: ASR Commercial |
$202.85
|
| Rate for Payer: BCBS Trust/PPO |
$170.41
|
| Rate for Payer: BCN Commercial |
$162.13
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$196.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Healthscope Commercial |
$209.12
|
| Rate for Payer: Healthscope Whirlpool |
$202.85
|
| Rate for Payer: Mclaren Commercial |
$188.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: Nomi Health Commercial |
$171.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.03
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.93 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Aetna Commercial |
$100.98
|
| Rate for Payer: ASR ASR |
$108.83
|
| Rate for Payer: ASR Commercial |
$108.83
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$105.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$108.83
|
| Rate for Payer: Mclaren Commercial |
$100.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.74
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Aetna Commercial |
$100.98
|
| Rate for Payer: Aetna Medicare |
$52.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: ASR ASR |
$108.83
|
| Rate for Payer: ASR Commercial |
$108.83
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$105.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$108.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.11
|
| Rate for Payer: Mclaren Commercial |
$100.98
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$57.32
|
| Rate for Payer: PHP Medicaid |
$27.93
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.31
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health Narrow Network |
$78.65
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP DNSP |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
OP
|
$524.15
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$188.04 |
| Max. Negotiated Rate |
$543.79 |
| Rate for Payer: Aetna Commercial |
$471.74
|
| Rate for Payer: Aetna Medicare |
$350.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: ASR ASR |
$508.43
|
| Rate for Payer: ASR Commercial |
$508.43
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCBS Trust/PPO |
$429.23
|
| Rate for Payer: BCN Commercial |
$406.37
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cofinity Commercial |
$492.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$524.15
|
| Rate for Payer: Healthscope Whirlpool |
$508.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$350.83
|
| Rate for Payer: Mclaren Commercial |
$471.74
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.53
|
| Rate for Payer: Nomi Health Commercial |
$429.80
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$385.91
|
| Rate for Payer: PHP Medicaid |
$188.04
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$459.26
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health Narrow Network |
$367.43
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Exchange |
$543.79
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP DNSP |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$188.04
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
IP
|
$524.15
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$340.70 |
| Max. Negotiated Rate |
$524.15 |
| Rate for Payer: Aetna Commercial |
$471.74
|
| Rate for Payer: ASR ASR |
$508.43
|
| Rate for Payer: ASR Commercial |
$508.43
|
| Rate for Payer: BCBS Trust/PPO |
$427.13
|
| Rate for Payer: BCN Commercial |
$406.37
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cofinity Commercial |
$492.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.32
|
| Rate for Payer: Healthscope Commercial |
$524.15
|
| Rate for Payer: Healthscope Whirlpool |
$508.43
|
| Rate for Payer: Mclaren Commercial |
$471.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.53
|
| Rate for Payer: Nomi Health Commercial |
$429.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.25
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
IP
|
$771.67
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$501.59 |
| Max. Negotiated Rate |
$771.67 |
| Rate for Payer: Aetna Commercial |
$694.50
|
| Rate for Payer: ASR ASR |
$748.52
|
| Rate for Payer: ASR Commercial |
$748.52
|
| Rate for Payer: BCBS Trust/PPO |
$628.83
|
| Rate for Payer: BCN Commercial |
$598.28
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cofinity Commercial |
$725.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.34
|
| Rate for Payer: Healthscope Commercial |
$771.67
|
| Rate for Payer: Healthscope Whirlpool |
$748.52
|
| Rate for Payer: Mclaren Commercial |
$694.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.92
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$679.07
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
OP
|
$771.67
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$427.04 |
| Max. Negotiated Rate |
$1,234.90 |
| Rate for Payer: Aetna Commercial |
$694.50
|
| Rate for Payer: Aetna Medicare |
$796.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: ASR ASR |
$748.52
|
| Rate for Payer: ASR Commercial |
$748.52
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCBS Trust/PPO |
$631.92
|
| Rate for Payer: BCN Commercial |
$598.28
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cofinity Commercial |
$725.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$771.67
|
| Rate for Payer: Healthscope Whirlpool |
$748.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$796.71
|
| Rate for Payer: Mclaren Commercial |
$694.50
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.92
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$876.38
|
| Rate for Payer: PHP Medicaid |
$427.04
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.14
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health Narrow Network |
$540.94
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$679.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Exchange |
$1,234.90
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP DNSP |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$427.04
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: Aetna Medicare |
$28.61
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$46.86
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.14
|
| Rate for Payer: Priority Health Narrow Network |
$40.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Trust/PPO |
$46.63
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
OP
|
$90.51
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.83 |
| Max. Negotiated Rate |
$1,234.90 |
| Rate for Payer: Aetna Commercial |
$81.46
|
| Rate for Payer: Aetna Medicare |
$796.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: ASR ASR |
$87.79
|
| Rate for Payer: ASR Commercial |
$87.79
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCBS Trust/PPO |
$74.12
|
| Rate for Payer: BCN Commercial |
$70.17
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Commercial |
$85.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$90.51
|
| Rate for Payer: Healthscope Whirlpool |
$87.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$796.71
|
| Rate for Payer: Mclaren Commercial |
$81.46
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$876.38
|
| Rate for Payer: PHP Medicaid |
$427.04
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health Narrow Network |
$63.45
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Exchange |
$1,234.90
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP DNSP |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$427.04
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
IP
|
$90.51
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.83 |
| Max. Negotiated Rate |
$90.51 |
| Rate for Payer: Aetna Commercial |
$81.46
|
| Rate for Payer: ASR ASR |
$87.79
|
| Rate for Payer: ASR Commercial |
$87.79
|
| Rate for Payer: BCBS Trust/PPO |
$73.76
|
| Rate for Payer: BCN Commercial |
$70.17
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Commercial |
$85.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Healthscope Commercial |
$90.51
|
| Rate for Payer: Healthscope Whirlpool |
$87.79
|
| Rate for Payer: Mclaren Commercial |
$81.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.65
|
|
|
HC PCP SCREEN URIN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Trust/PPO |
$77.03
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
|
|
HC PCP SCREEN URIN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$96.32 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.41
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.83
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PCP SCREEN URN.
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.47
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC PCP SCREEN URN.
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$394.74
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$157.90 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$355.27
|
| Rate for Payer: Aetna Medicare |
$197.37
|
| Rate for Payer: ASR ASR |
$382.90
|
| Rate for Payer: ASR Commercial |
$382.90
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS Trust/PPO |
$323.25
|
| Rate for Payer: BCN Commercial |
$306.04
|
| Rate for Payer: Cash Price |
$315.79
|
| Rate for Payer: Cofinity Commercial |
$371.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.79
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Healthscope Whirlpool |
$382.90
|
| Rate for Payer: Mclaren Commercial |
$355.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.53
|
| Rate for Payer: Nomi Health Commercial |
$323.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$345.87
|
| Rate for Payer: Priority Health Narrow Network |
$276.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$347.37
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$394.74
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$256.58 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$355.27
|
| Rate for Payer: ASR ASR |
$382.90
|
| Rate for Payer: ASR Commercial |
$382.90
|
| Rate for Payer: BCBS Trust/PPO |
$321.67
|
| Rate for Payer: BCN Commercial |
$306.04
|
| Rate for Payer: Cash Price |
$315.79
|
| Rate for Payer: Cofinity Commercial |
$371.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.79
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Healthscope Whirlpool |
$382.90
|
| Rate for Payer: Mclaren Commercial |
$355.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.53
|
| Rate for Payer: Nomi Health Commercial |
$323.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$347.37
|
|
|
HC PEAK FLOW METER
|
Facility
|
IP
|
$29.15
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.95 |
| Max. Negotiated Rate |
$29.15 |
| Rate for Payer: Aetna Commercial |
$26.23
|
| Rate for Payer: ASR ASR |
$28.28
|
| Rate for Payer: ASR Commercial |
$28.28
|
| Rate for Payer: BCBS Trust/PPO |
$23.75
|
| Rate for Payer: BCN Commercial |
$22.60
|
| Rate for Payer: Cash Price |
$23.32
|
| Rate for Payer: Cofinity Commercial |
$27.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.32
|
| Rate for Payer: Healthscope Commercial |
$29.15
|
| Rate for Payer: Healthscope Whirlpool |
$28.28
|
| Rate for Payer: Mclaren Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.78
|
| Rate for Payer: Nomi Health Commercial |
$23.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.65
|
|
|
HC PEAK FLOW METER
|
Facility
|
OP
|
$29.15
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$29.15 |
| Rate for Payer: Aetna Commercial |
$26.23
|
| Rate for Payer: Aetna Medicare |
$14.57
|
| Rate for Payer: ASR ASR |
$28.28
|
| Rate for Payer: ASR Commercial |
$28.28
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS Trust/PPO |
$23.87
|
| Rate for Payer: BCN Commercial |
$22.60
|
| Rate for Payer: Cash Price |
$23.32
|
| Rate for Payer: Cofinity Commercial |
$27.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.32
|
| Rate for Payer: Healthscope Commercial |
$29.15
|
| Rate for Payer: Healthscope Whirlpool |
$28.28
|
| Rate for Payer: Mclaren Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.78
|
| Rate for Payer: Nomi Health Commercial |
$23.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.54
|
| Rate for Payer: Priority Health Narrow Network |
$20.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.65
|
|
