|
HC PH GASTRIC
|
Facility
|
OP
|
$24.68
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna Commercial |
$22.21
|
| 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 |
$23.94
|
| Rate for Payer: ASR Commercial |
$23.94
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$20.21
|
| Rate for Payer: BCN Commercial |
$19.13
|
| Rate for Payer: BCN Medicare Advantage |
$6.71
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cofinity Commercial |
$23.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.71
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Healthscope Whirlpool |
$23.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.71
|
| Rate for Payer: Mclaren Commercial |
$22.21
|
| Rate for Payer: Mclaren Medicaid |
$3.60
|
| 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 |
$3.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.98
|
| Rate for Payer: Nomi Health Commercial |
$20.24
|
| 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 |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.62
|
| Rate for Payer: Priority Health Medicare |
$6.71
|
| Rate for Payer: Priority Health Narrow Network |
$17.30
|
| Rate for Payer: Railroad Medicare Medicare |
$6.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.71
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$6.71
|
| Rate for Payer: UHCCP DNSP |
$6.71
|
| Rate for Payer: UHCCP Medicaid |
$3.60
|
| Rate for Payer: VA VA |
$6.71
|
|
|
HC PH GASTRIC
|
Facility
|
IP
|
$24.68
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.04 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna Commercial |
$22.21
|
| Rate for Payer: ASR ASR |
$23.94
|
| Rate for Payer: ASR Commercial |
$23.94
|
| Rate for Payer: BCBS Trust/PPO |
$20.11
|
| Rate for Payer: BCN Commercial |
$19.13
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cofinity Commercial |
$23.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.74
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Healthscope Whirlpool |
$23.94
|
| Rate for Payer: Mclaren Commercial |
$22.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.98
|
| Rate for Payer: Nomi Health Commercial |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.72
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.98 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: ASR Commercial |
$93.99
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: Aetna Medicare |
$48.45
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: ASR Commercial |
$93.99
|
| Rate for Payer: BCBS Complete |
$38.76
|
| Rate for Payer: BCBS Trust/PPO |
$79.35
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.90
|
| Rate for Payer: Priority Health Narrow Network |
$67.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
OP
|
$75.48
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$75.48 |
| Rate for Payer: Aetna Commercial |
$67.93
|
| 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 |
$73.22
|
| Rate for Payer: ASR Commercial |
$73.22
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$61.81
|
| Rate for Payer: BCN Commercial |
$58.52
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$70.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$75.48
|
| Rate for Payer: Healthscope Whirlpool |
$73.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.52
|
| Rate for Payer: Mclaren Commercial |
$67.93
|
| Rate for Payer: Mclaren Medicaid |
$8.85
|
| 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 |
$9.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$61.89
|
| 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 |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.14
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow Network |
$52.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.52
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UHC Medicare Advantage |
$16.52
|
| Rate for Payer: UHCCP DNSP |
$16.52
|
| Rate for Payer: UHCCP Medicaid |
$8.85
|
| Rate for Payer: VA VA |
$16.52
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
IP
|
$75.48
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.06 |
| Max. Negotiated Rate |
$75.48 |
| Rate for Payer: Aetna Commercial |
$67.93
|
| Rate for Payer: ASR ASR |
$73.22
|
| Rate for Payer: ASR Commercial |
$73.22
|
| Rate for Payer: BCBS Trust/PPO |
$61.51
|
| Rate for Payer: BCN Commercial |
$58.52
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$70.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Healthscope Commercial |
$75.48
|
| Rate for Payer: Healthscope Whirlpool |
$73.22
|
| Rate for Payer: Mclaren Commercial |
$67.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$61.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.42
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.03 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: ASR ASR |
$82.12
|
| Rate for Payer: ASR Commercial |
$82.12
|
| Rate for Payer: BCBS Trust/PPO |
$68.99
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$79.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| 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 |
$82.12
|
| Rate for Payer: ASR Commercial |
$82.12
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$69.33
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$79.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.52
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$8.85
|
| 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 |
$9.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| 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 |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.18
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow Network |
$59.35
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.52
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UHC Medicare Advantage |
$16.52
|
| Rate for Payer: UHCCP DNSP |
$16.52
|
| Rate for Payer: UHCCP Medicaid |
$8.85
|
| Rate for Payer: VA VA |
$16.52
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$55.14 |
| Rate for Payer: Aetna Commercial |
$49.63
|
| 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 |
$53.49
|
| Rate for Payer: ASR Commercial |
$53.49
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$45.15
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$55.14
|
| Rate for Payer: Healthscope Whirlpool |
$53.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$49.63
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| 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 |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| 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 |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.31
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$38.65
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.84 |
| Max. Negotiated Rate |
$55.14 |
| Rate for Payer: Aetna Commercial |
$49.63
|
| Rate for Payer: ASR ASR |
$53.49
|
| Rate for Payer: ASR Commercial |
$53.49
|
| Rate for Payer: BCBS Trust/PPO |
$44.93
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$55.14
|
| Rate for Payer: Healthscope Whirlpool |
$53.49
|
| Rate for Payer: Mclaren Commercial |
$49.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.52
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| 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 |
$52.48
|
| Rate for Payer: ASR Commercial |
$52.48
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$44.30
|
| Rate for Payer: BCN Commercial |
$41.94
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Healthscope Whirlpool |
$52.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| 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 |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| 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 |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.40
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$37.92
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: ASR Commercial |
$52.48
|
| Rate for Payer: BCBS Trust/PPO |
$44.09
|
| Rate for Payer: BCN Commercial |
$41.94
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Healthscope Whirlpool |
$52.48
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
OP
|
$282.13
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$282.13 |
| Rate for Payer: Aetna Commercial |
$253.92
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$273.67
|
| Rate for Payer: ASR Commercial |
$273.67
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$231.04
|
| Rate for Payer: BCN Commercial |
$218.74
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$225.70
|
| Rate for Payer: Cash Price |
$225.70
|
| Rate for Payer: Cofinity Commercial |
$265.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$282.13
|
| Rate for Payer: Healthscope Whirlpool |
$273.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$253.92
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.81
|
| Rate for Payer: Nomi Health Commercial |
$231.35
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.29
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$181.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
IP
|
$282.13
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$183.38 |
| Max. Negotiated Rate |
$282.13 |
| Rate for Payer: Aetna Commercial |
$253.92
|
| Rate for Payer: ASR ASR |
$273.67
|
| Rate for Payer: ASR Commercial |
$273.67
|
| Rate for Payer: BCBS Trust/PPO |
$229.91
|
| Rate for Payer: BCN Commercial |
$218.74
|
| Rate for Payer: Cash Price |
$225.70
|
| Rate for Payer: Cofinity Commercial |
$265.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.70
|
| Rate for Payer: Healthscope Commercial |
$282.13
|
| Rate for Payer: Healthscope Whirlpool |
$273.67
|
| Rate for Payer: Mclaren Commercial |
$253.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.81
|
| Rate for Payer: Nomi Health Commercial |
$231.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.27
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$227.29 |
| Rate for Payer: Aetna Commercial |
$189.11
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$203.82
|
| Rate for Payer: ASR Commercial |
$203.82
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$172.07
|
| Rate for Payer: BCN Commercial |
$162.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$210.12
|
| Rate for Payer: Healthscope Whirlpool |
$203.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$189.11
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.29
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$181.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$136.58 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$189.11
|
| Rate for Payer: ASR ASR |
$203.82
|
| Rate for Payer: ASR Commercial |
$203.82
|
| Rate for Payer: BCBS Trust/PPO |
$171.23
|
| Rate for Payer: BCN Commercial |
$162.91
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Healthscope Commercial |
$210.12
|
| Rate for Payer: Healthscope Whirlpool |
$203.82
|
| Rate for Payer: Mclaren Commercial |
$189.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.91
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$136.58 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$189.11
|
| Rate for Payer: ASR ASR |
$203.82
|
| Rate for Payer: ASR Commercial |
$203.82
|
| Rate for Payer: BCBS Trust/PPO |
$171.23
|
| Rate for Payer: BCN Commercial |
$162.91
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Healthscope Commercial |
$210.12
|
| Rate for Payer: Healthscope Whirlpool |
$203.82
|
| Rate for Payer: Mclaren Commercial |
$189.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.91
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$189.11
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$203.82
|
| Rate for Payer: ASR Commercial |
$203.82
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$172.07
|
| Rate for Payer: BCN Commercial |
$162.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$210.12
|
| Rate for Payer: Healthscope Whirlpool |
$203.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$189.11
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.25
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$154.60
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$4.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.92
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.74
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.74
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.74
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.74
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Mclaren Medicare |
$4.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.98
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$4.50
|
| Rate for Payer: PACE SWMI |
$4.74
|
| Rate for Payer: PHP Commercial |
$5.21
|
| Rate for Payer: PHP Medicaid |
$2.54
|
| Rate for Payer: PHP Medicare Advantage |
$4.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.21
|
| Rate for Payer: Priority Health Medicare |
$4.74
|
| Rate for Payer: Priority Health Narrow Network |
$15.37
|
| Rate for Payer: Railroad Medicare Medicare |
$4.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.74
|
| Rate for Payer: UHC Exchange |
$7.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.74
|
| Rate for Payer: UHCCP DNSP |
$4.74
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$4.74
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
IP
|
$52.94
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.41 |
| Max. Negotiated Rate |
$52.94 |
| Rate for Payer: Aetna Commercial |
$47.65
|
| Rate for Payer: ASR ASR |
$51.35
|
| Rate for Payer: ASR Commercial |
$51.35
|
| Rate for Payer: BCBS Trust/PPO |
$43.14
|
| Rate for Payer: BCN Commercial |
$41.04
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cofinity Commercial |
$49.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.35
|
| Rate for Payer: Healthscope Commercial |
$52.94
|
| Rate for Payer: Healthscope Whirlpool |
$51.35
|
| Rate for Payer: Mclaren Commercial |
$47.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.00
|
| Rate for Payer: Nomi Health Commercial |
$43.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.59
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
OP
|
$52.94
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$52.94 |
| Rate for Payer: Aetna Commercial |
$47.65
|
| Rate for Payer: Aetna Medicare |
$5.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.22
|
| Rate for Payer: ASR ASR |
$51.35
|
| Rate for Payer: ASR Commercial |
$51.35
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS MAPPO |
$5.78
|
| Rate for Payer: BCBS Trust/PPO |
$43.35
|
| Rate for Payer: BCN Commercial |
$41.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.78
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cofinity Commercial |
$49.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.78
|
| Rate for Payer: Healthscope Commercial |
$52.94
|
| Rate for Payer: Healthscope Whirlpool |
$51.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.78
|
| Rate for Payer: Mclaren Commercial |
$47.65
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Mclaren Medicare |
$5.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.07
|
| Rate for Payer: Meridian Medicaid |
$3.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.00
|
| Rate for Payer: Nomi Health Commercial |
$43.41
|
| Rate for Payer: PACE Medicare |
$5.49
|
| Rate for Payer: PACE SWMI |
$5.78
|
| Rate for Payer: PHP Commercial |
$6.36
|
| Rate for Payer: PHP Medicaid |
$3.10
|
| Rate for Payer: PHP Medicare Advantage |
$5.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.96
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow Network |
$17.57
|
| Rate for Payer: Railroad Medicare Medicare |
$5.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.78
|
| Rate for Payer: UHC Exchange |
$8.96
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: UHCCP DNSP |
$5.78
|
| Rate for Payer: UHCCP Medicaid |
$3.10
|
| Rate for Payer: VA VA |
$5.78
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$37.46 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: Aetna Medicare |
$46.82
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: ASR Commercial |
$90.83
|
| Rate for Payer: BCBS Complete |
$37.46
|
| Rate for Payer: BCBS Trust/PPO |
$76.68
|
| Rate for Payer: BCN Commercial |
$72.60
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Healthscope Whirlpool |
$90.83
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.86
|
| Rate for Payer: Priority Health Narrow Network |
$61.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$60.87 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: ASR Commercial |
$90.83
|
| Rate for Payer: BCBS Trust/PPO |
$76.31
|
| Rate for Payer: BCN Commercial |
$72.60
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Healthscope Whirlpool |
$90.83
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
|
|
HC PICC INTRODUCER
|
Facility
|
OP
|
$98.32
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.33 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$88.49
|
| Rate for Payer: Aetna Medicare |
$49.16
|
| Rate for Payer: ASR ASR |
$95.37
|
| Rate for Payer: ASR Commercial |
$95.37
|
| Rate for Payer: BCBS Complete |
$39.33
|
| Rate for Payer: BCBS Trust/PPO |
$80.51
|
| Rate for Payer: BCN Commercial |
$76.23
|
| Rate for Payer: Cash Price |
$78.66
|
| Rate for Payer: Cofinity Commercial |
$92.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.66
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Healthscope Whirlpool |
$95.37
|
| Rate for Payer: Mclaren Commercial |
$88.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.57
|
| Rate for Payer: Nomi Health Commercial |
$80.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.15
|
| Rate for Payer: Priority Health Narrow Network |
$68.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.52
|
|
