|
HC PNEUMOCYSTIS BY RAPID PCR
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600170
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$99.45 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: ASR ASR |
$148.41
|
| Rate for Payer: ASR Commercial |
$148.41
|
| Rate for Payer: BCBS Trust/PPO |
$124.68
|
| Rate for Payer: BCN Commercial |
$118.62
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$143.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Healthscope Whirlpool |
$148.41
|
| Rate for Payer: Mclaren Commercial |
$137.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.64
|
|
|
HC PNEUMONIAE AB IGM BY IFA
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$148.92 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$121.95
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.85
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$47.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC PNEUMONIAE AB IGM BY IFA
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$148.92 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Trust/PPO |
$121.35
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
|
|
HC POC BASIC METABOLIC PANEL W/ICAL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100696
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC POC BASIC METABOLIC PANEL W/ICAL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100696
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.73
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: PHP Medicaid |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.73
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$13.73
|
| Rate for Payer: UHCCP DNSP |
$13.73
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$13.73
|
|
|
HC POC BLOOD GAS
|
Facility
|
OP
|
$165.22
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.22 |
| Max. Negotiated Rate |
$165.22 |
| Rate for Payer: Aetna Commercial |
$148.70
|
| Rate for Payer: Aetna Medicare |
$78.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: ASR ASR |
$160.26
|
| Rate for Payer: ASR Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$44.33
|
| Rate for Payer: BCBS MAPPO |
$78.77
|
| Rate for Payer: BCBS Trust/PPO |
$135.30
|
| Rate for Payer: BCN Commercial |
$128.10
|
| Rate for Payer: BCN Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$132.18
|
| Rate for Payer: Cash Price |
$132.18
|
| Rate for Payer: Cofinity Commercial |
$155.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.77
|
| Rate for Payer: Healthscope Commercial |
$165.22
|
| Rate for Payer: Healthscope Whirlpool |
$160.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$78.77
|
| Rate for Payer: Mclaren Commercial |
$148.70
|
| Rate for Payer: Mclaren Medicaid |
$42.22
|
| Rate for Payer: Mclaren Medicare |
$78.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.71
|
| Rate for Payer: Meridian Medicaid |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.44
|
| Rate for Payer: Nomi Health Commercial |
$135.48
|
| Rate for Payer: PACE Medicare |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.77
|
| Rate for Payer: PHP Commercial |
$86.65
|
| Rate for Payer: PHP Medicaid |
$42.22
|
| Rate for Payer: PHP Medicare Advantage |
$78.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.77
|
| Rate for Payer: Priority Health Medicare |
$78.77
|
| Rate for Payer: Priority Health Narrow Network |
$115.82
|
| Rate for Payer: Railroad Medicare Medicare |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.77
|
| Rate for Payer: UHC Exchange |
$122.09
|
| Rate for Payer: UHC Medicare Advantage |
$78.77
|
| Rate for Payer: UHCCP DNSP |
$78.77
|
| Rate for Payer: UHCCP Medicaid |
$42.22
|
| Rate for Payer: VA VA |
$78.77
|
|
|
HC POC BLOOD GAS
|
Facility
|
IP
|
$165.22
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$107.39 |
| Max. Negotiated Rate |
$165.22 |
| Rate for Payer: Aetna Commercial |
$148.70
|
| Rate for Payer: ASR ASR |
$160.26
|
| Rate for Payer: ASR Commercial |
$160.26
|
| Rate for Payer: BCBS Trust/PPO |
$134.64
|
| Rate for Payer: BCN Commercial |
$128.10
|
| Rate for Payer: Cash Price |
$132.18
|
| Rate for Payer: Cofinity Commercial |
$155.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.18
|
| Rate for Payer: Healthscope Commercial |
$165.22
|
| Rate for Payer: Healthscope Whirlpool |
$160.26
|
| Rate for Payer: Mclaren Commercial |
$148.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.44
|
| Rate for Payer: Nomi Health Commercial |
$135.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.39
|
|
|
HC POC BLOOD GAS CALC O2 SAT
|
Facility
|
OP
|
$109.66
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100700
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.97 |
| Max. Negotiated Rate |
$163.06 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$26.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.59
|
| Rate for Payer: ASR ASR |
$106.37
|
| Rate for Payer: ASR Commercial |
$106.37
|
| Rate for Payer: BCBS Complete |
$14.67
|
| Rate for Payer: BCBS MAPPO |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$89.80
|
| Rate for Payer: BCN Commercial |
$85.02
|
| Rate for Payer: BCN Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Commercial |
$103.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$109.66
|
| Rate for Payer: Healthscope Whirlpool |
$106.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.07
|
| Rate for Payer: Mclaren Commercial |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$13.97
|
| Rate for Payer: Mclaren Medicare |
$26.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.37
|
| Rate for Payer: Meridian Medicaid |
$14.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$89.92
|
| Rate for Payer: PACE Medicare |
$24.77
|
| Rate for Payer: PACE SWMI |
$26.07
|
| Rate for Payer: PHP Commercial |
$28.68
|
| Rate for Payer: PHP Medicaid |
$13.97
|
| Rate for Payer: PHP Medicare Advantage |
$26.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.06
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health Narrow Network |
$130.45
|
| Rate for Payer: Railroad Medicare Medicare |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.07
|
| Rate for Payer: UHC Exchange |
$40.41
|
| Rate for Payer: UHC Medicare Advantage |
$26.07
|
| Rate for Payer: UHCCP DNSP |
$26.07
|
| Rate for Payer: UHCCP Medicaid |
$13.97
|
| Rate for Payer: VA VA |
$26.07
|
|
|
HC POC BLOOD GAS CALC O2 SAT
|
Facility
|
IP
|
$109.66
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100700
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.28 |
| Max. Negotiated Rate |
$109.66 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: ASR ASR |
$106.37
|
| Rate for Payer: ASR Commercial |
$106.37
|
| Rate for Payer: BCBS Trust/PPO |
$89.36
|
| Rate for Payer: BCN Commercial |
$85.02
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Commercial |
$103.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Healthscope Commercial |
$109.66
|
| Rate for Payer: Healthscope Whirlpool |
$106.37
|
| Rate for Payer: Mclaren Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$89.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.50
|
|
|
HC POC CARBOXYHEMOGLOBIN QUANT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100726
|
|
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 POC CARBOXYHEMOGLOBIN QUANT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$92.78 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.40
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$12.32
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$12.32
|
| 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 |
$12.32
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.32
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$6.60
|
| Rate for Payer: Mclaren Medicare |
$12.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.94
|
| Rate for Payer: Meridian Medicaid |
$6.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$11.70
|
| Rate for Payer: PACE SWMI |
$12.32
|
| Rate for Payer: PHP Commercial |
$13.55
|
| Rate for Payer: PHP Medicaid |
$6.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.78
|
| Rate for Payer: Priority Health Medicare |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$74.22
|
| Rate for Payer: Railroad Medicare Medicare |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.32
|
| Rate for Payer: UHC Exchange |
$19.10
|
| Rate for Payer: UHC Medicare Advantage |
$12.32
|
| Rate for Payer: UHCCP DNSP |
$12.32
|
| Rate for Payer: UHCCP Medicaid |
$6.60
|
| Rate for Payer: VA VA |
$12.32
|
|
|
HC POC CHLORIDE
|
Facility
|
OP
|
$19.77
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100500
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna Commercial |
$17.79
|
| Rate for Payer: Aetna Medicare |
$4.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.75
|
| Rate for Payer: ASR ASR |
$19.18
|
| Rate for Payer: ASR Commercial |
$19.18
|
| Rate for Payer: BCBS Complete |
$2.59
|
| Rate for Payer: BCBS MAPPO |
$4.60
|
| Rate for Payer: BCBS Trust/PPO |
$16.19
|
| Rate for Payer: BCN Commercial |
$15.33
|
| Rate for Payer: BCN Medicare Advantage |
$4.60
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.60
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Healthscope Whirlpool |
$19.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.60
|
| Rate for Payer: Mclaren Commercial |
$17.79
|
| Rate for Payer: Mclaren Medicaid |
$2.47
|
| Rate for Payer: Mclaren Medicare |
$4.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.83
|
| Rate for Payer: Meridian Medicaid |
$2.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: PACE Medicare |
$4.37
|
| Rate for Payer: PACE SWMI |
$4.60
|
| Rate for Payer: PHP Commercial |
$5.06
|
| Rate for Payer: PHP Medicaid |
$2.47
|
| Rate for Payer: PHP Medicare Advantage |
$4.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.32
|
| Rate for Payer: Priority Health Medicare |
$4.60
|
| Rate for Payer: Priority Health Narrow Network |
$13.86
|
| Rate for Payer: Railroad Medicare Medicare |
$4.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.60
|
| Rate for Payer: UHC Exchange |
$7.13
|
| Rate for Payer: UHC Medicare Advantage |
$4.60
|
| Rate for Payer: UHCCP DNSP |
$4.60
|
| Rate for Payer: UHCCP Medicaid |
$2.47
|
| Rate for Payer: VA VA |
$4.60
|
|
|
HC POC CHLORIDE
|
Facility
|
IP
|
$19.77
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100500
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna Commercial |
$17.79
|
| Rate for Payer: ASR ASR |
$19.18
|
| Rate for Payer: ASR Commercial |
$19.18
|
| Rate for Payer: BCBS Trust/PPO |
$16.11
|
| Rate for Payer: BCN Commercial |
$15.33
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Healthscope Whirlpool |
$19.18
|
| Rate for Payer: Mclaren Commercial |
$17.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.40
|
|
|
HC POC COVID ABBOTT ID NOW
|
Facility
|
OP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600328
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$146.33
|
| Rate for Payer: ASR Commercial |
$146.33
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$123.54
|
| Rate for Payer: BCN Commercial |
$116.96
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$141.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$150.86
|
| Rate for Payer: Healthscope Whirlpool |
$146.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$135.77
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.74
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$46.99
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC POC COVID ABBOTT ID NOW
|
Facility
|
IP
|
$150.86
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600328
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$98.06 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: ASR ASR |
$146.33
|
| Rate for Payer: ASR Commercial |
$146.33
|
| Rate for Payer: BCBS Trust/PPO |
$122.94
|
| Rate for Payer: BCN Commercial |
$116.96
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$141.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$150.86
|
| Rate for Payer: Healthscope Whirlpool |
$146.33
|
| Rate for Payer: Mclaren Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.76
|
|
|
HC POC CREATININE SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$24.71 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| 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 |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.12
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.74
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$5.63
|
| Rate for Payer: PHP Medicaid |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.71
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health Narrow Network |
$19.77
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.94
|
| Rate for Payer: UHC Medicare Advantage |
$5.12
|
| Rate for Payer: UHCCP DNSP |
$5.12
|
| Rate for Payer: UHCCP Medicaid |
$2.74
|
| Rate for Payer: VA VA |
$5.12
|
|
|
HC POC CREATININE SERUM
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100703
|
|
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 POC ELECTROLYTES, WHOLE BLOOD
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100766
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: ASR Commercial |
$29.10
|
| Rate for Payer: BCBS Trust/PPO |
$24.45
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC POC ELECTROLYTES, WHOLE BLOOD
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100766
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$80.15 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: ASR Commercial |
$29.10
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.57
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.01
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| Rate for Payer: Mclaren Medicare |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: PACE Medicare |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$7.71
|
| Rate for Payer: PHP Medicaid |
$3.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.15
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Narrow Network |
$64.12
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.01
|
| Rate for Payer: UHC Exchange |
$10.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.01
|
| Rate for Payer: UHCCP DNSP |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$3.76
|
| Rate for Payer: VA VA |
$7.01
|
|
|
HC POC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100763
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC POC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100763
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.48
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$2.47
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.38
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$2.35
|
| Rate for Payer: Mclaren Medicare |
$4.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Meridian Medicaid |
$2.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Medicare |
$4.16
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Commercial |
$4.82
|
| Rate for Payer: PHP Medicaid |
$2.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.15
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Narrow Network |
$41.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.38
|
| Rate for Payer: UHC Exchange |
$6.79
|
| Rate for Payer: UHC Medicare Advantage |
$4.38
|
| Rate for Payer: UHCCP DNSP |
$4.38
|
| Rate for Payer: UHCCP Medicaid |
$2.35
|
| Rate for Payer: VA VA |
$4.38
|
|
|
HC POC GLUCOSE LEVEL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100702
|
|
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 POC GLUCOSE LEVEL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$3.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.91
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.21
|
| Rate for Payer: BCBS MAPPO |
$3.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$3.93
|
| 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 |
$3.93
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.93
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.11
|
| Rate for Payer: Mclaren Medicare |
$3.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.13
|
| Rate for Payer: Meridian Medicaid |
$2.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$3.73
|
| Rate for Payer: PACE SWMI |
$3.93
|
| Rate for Payer: PHP Commercial |
$4.32
|
| Rate for Payer: PHP Medicaid |
$2.11
|
| Rate for Payer: PHP Medicare Advantage |
$3.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.81
|
| Rate for Payer: Priority Health Medicare |
$3.93
|
| Rate for Payer: Priority Health Narrow Network |
$20.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.93
|
| Rate for Payer: UHC Exchange |
$6.09
|
| Rate for Payer: UHC Medicare Advantage |
$3.93
|
| Rate for Payer: UHCCP DNSP |
$3.93
|
| Rate for Payer: UHCCP Medicaid |
$2.11
|
| Rate for Payer: VA VA |
$3.93
|
|
|
HC POC GLYCOHEMOGLOBIN (A1C)
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
30100764
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$71.37 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.14
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Complete |
$5.46
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.71
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$5.20
|
| Rate for Payer: Mclaren Medicare |
$9.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Meridian Medicaid |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Medicare |
$9.22
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PHP Commercial |
$10.68
|
| Rate for Payer: PHP Medicaid |
$5.20
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.37
|
| Rate for Payer: Priority Health Medicare |
$9.71
|
| Rate for Payer: Priority Health Narrow Network |
$57.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.71
|
| Rate for Payer: UHC Exchange |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$9.71
|
| Rate for Payer: UHCCP DNSP |
$9.71
|
| Rate for Payer: UHCCP Medicaid |
$5.20
|
| Rate for Payer: VA VA |
$9.71
|
|
|
HC POC GLYCOHEMOGLOBIN (A1C)
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
30100764
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$29.67
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
