|
HC POC SODIUM
|
Facility
|
OP
|
$32.87
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$32.87 |
| Rate for Payer: Aetna Commercial |
$29.58
|
| Rate for Payer: Aetna Medicare |
$4.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.01
|
| Rate for Payer: ASR ASR |
$31.88
|
| Rate for Payer: ASR Commercial |
$31.88
|
| Rate for Payer: BCBS Complete |
$2.71
|
| Rate for Payer: BCBS MAPPO |
$4.81
|
| Rate for Payer: BCBS Trust/PPO |
$26.92
|
| Rate for Payer: BCN Commercial |
$25.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.81
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$30.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.81
|
| Rate for Payer: Healthscope Commercial |
$32.87
|
| Rate for Payer: Healthscope Whirlpool |
$31.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.81
|
| Rate for Payer: Mclaren Commercial |
$29.58
|
| Rate for Payer: Mclaren Medicaid |
$2.58
|
| Rate for Payer: Mclaren Medicare |
$4.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.05
|
| Rate for Payer: Meridian Medicaid |
$2.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.94
|
| Rate for Payer: Nomi Health Commercial |
$26.95
|
| Rate for Payer: PACE Medicare |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.81
|
| Rate for Payer: PHP Commercial |
$5.29
|
| Rate for Payer: PHP Medicaid |
$2.58
|
| Rate for Payer: PHP Medicare Advantage |
$4.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.02
|
| Rate for Payer: Priority Health Medicare |
$4.81
|
| Rate for Payer: Priority Health Narrow Network |
$13.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.81
|
| Rate for Payer: UHC Exchange |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$4.81
|
| Rate for Payer: UHCCP DNSP |
$4.81
|
| Rate for Payer: UHCCP Medicaid |
$2.58
|
| Rate for Payer: VA VA |
$4.81
|
|
|
HC POC TOTAL CO2
|
Facility
|
OP
|
$18.18
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$24.71 |
| Rate for Payer: Aetna Commercial |
$16.36
|
| Rate for Payer: Aetna Medicare |
$4.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.10
|
| Rate for Payer: ASR ASR |
$17.63
|
| Rate for Payer: ASR Commercial |
$17.63
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$4.88
|
| Rate for Payer: BCBS Trust/PPO |
$14.89
|
| Rate for Payer: BCN Commercial |
$14.09
|
| Rate for Payer: BCN Medicare Advantage |
$4.88
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.88
|
| Rate for Payer: Healthscope Commercial |
$18.18
|
| Rate for Payer: Healthscope Whirlpool |
$17.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.88
|
| Rate for Payer: Mclaren Commercial |
$16.36
|
| Rate for Payer: Mclaren Medicaid |
$2.62
|
| Rate for Payer: Mclaren Medicare |
$4.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.12
|
| Rate for Payer: Meridian Medicaid |
$2.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.45
|
| Rate for Payer: Nomi Health Commercial |
$14.91
|
| Rate for Payer: PACE Medicare |
$4.64
|
| Rate for Payer: PACE SWMI |
$4.88
|
| Rate for Payer: PHP Commercial |
$5.37
|
| Rate for Payer: PHP Medicaid |
$2.62
|
| Rate for Payer: PHP Medicare Advantage |
$4.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.71
|
| Rate for Payer: Priority Health Medicare |
$4.88
|
| Rate for Payer: Priority Health Narrow Network |
$19.77
|
| Rate for Payer: Railroad Medicare Medicare |
$4.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.88
|
| Rate for Payer: UHC Exchange |
$7.56
|
| Rate for Payer: UHC Medicare Advantage |
$4.88
|
| Rate for Payer: UHCCP DNSP |
$4.88
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: VA VA |
$4.88
|
|
|
HC POC TOTAL CO2
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$18.18 |
| Rate for Payer: Aetna Commercial |
$16.36
|
| Rate for Payer: ASR ASR |
$17.63
|
| Rate for Payer: ASR Commercial |
$17.63
|
| Rate for Payer: BCBS Trust/PPO |
$14.81
|
| Rate for Payer: BCN Commercial |
$14.09
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$18.18
|
| Rate for Payer: Healthscope Whirlpool |
$17.63
|
| Rate for Payer: Mclaren Commercial |
$16.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.45
|
| Rate for Payer: Nomi Health Commercial |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.00
|
|
|
HC POC UA DIPSTICK, AUTO
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700014
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$21.22 |
| Rate for Payer: Aetna Commercial |
$19.10
|
| Rate for Payer: Aetna Medicare |
$2.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
| Rate for Payer: ASR ASR |
$20.58
|
| Rate for Payer: ASR Commercial |
$20.58
|
| Rate for Payer: BCBS Complete |
$1.27
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$17.38
|
| Rate for Payer: BCN Commercial |
$16.45
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$21.22
|
| Rate for Payer: Healthscope Whirlpool |
$20.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.25
|
| Rate for Payer: Mclaren Commercial |
$19.10
|
| Rate for Payer: Mclaren Medicaid |
$1.21
|
| Rate for Payer: Mclaren Medicare |
$2.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Meridian Medicaid |
$1.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: Nomi Health Commercial |
$17.40
|
| Rate for Payer: PACE Medicare |
$2.14
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$2.48
|
| Rate for Payer: PHP Medicaid |
$1.21
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.88
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow Network |
$7.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
| Rate for Payer: UHC Exchange |
$3.49
|
| Rate for Payer: UHC Medicare Advantage |
$2.25
|
| Rate for Payer: UHCCP DNSP |
$2.25
|
| Rate for Payer: UHCCP Medicaid |
$1.21
|
| Rate for Payer: VA VA |
$2.25
|
|
|
HC POC UA DIPSTICK, AUTO
|
Facility
|
IP
|
$21.22
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700014
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$21.22 |
| Rate for Payer: Aetna Commercial |
$19.10
|
| Rate for Payer: ASR ASR |
$20.58
|
| Rate for Payer: ASR Commercial |
$20.58
|
| Rate for Payer: BCBS Trust/PPO |
$17.29
|
| Rate for Payer: BCN Commercial |
$16.45
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$21.22
|
| Rate for Payer: Healthscope Whirlpool |
$20.58
|
| Rate for Payer: Mclaren Commercial |
$19.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: Nomi Health Commercial |
$17.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.67
|
|
|
HC POC UA DIPSTICK, MANUAL
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700013
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: Aetna Medicare |
$3.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.35
|
| Rate for Payer: ASR ASR |
$12.11
|
| Rate for Payer: ASR Commercial |
$12.11
|
| Rate for Payer: BCBS Complete |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCBS Trust/PPO |
$10.22
|
| Rate for Payer: BCN Commercial |
$9.68
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Healthscope Whirlpool |
$12.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.48
|
| Rate for Payer: Mclaren Commercial |
$11.23
|
| Rate for Payer: Mclaren Medicaid |
$1.87
|
| Rate for Payer: Mclaren Medicare |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Meridian Medicaid |
$1.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: PACE Medicare |
$3.31
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Commercial |
$3.83
|
| Rate for Payer: PHP Medicaid |
$1.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.68
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$6.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.48
|
| Rate for Payer: UHC Exchange |
$5.39
|
| Rate for Payer: UHC Medicare Advantage |
$3.48
|
| Rate for Payer: UHCCP DNSP |
$3.48
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
| Rate for Payer: VA VA |
$3.48
|
|
|
HC POC UA DIPSTICK, MANUAL
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700013
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.23
|
| Rate for Payer: ASR ASR |
$12.11
|
| Rate for Payer: ASR Commercial |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$10.17
|
| Rate for Payer: BCN Commercial |
$9.68
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Healthscope Whirlpool |
$12.11
|
| Rate for Payer: Mclaren Commercial |
$11.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.98
|
|
|
HC POC UREA NITROGEN
|
Facility
|
IP
|
$15.77
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$15.77 |
| Rate for Payer: Aetna Commercial |
$14.19
|
| Rate for Payer: ASR ASR |
$15.30
|
| Rate for Payer: ASR Commercial |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$12.85
|
| Rate for Payer: BCN Commercial |
$12.23
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Healthscope Commercial |
$15.77
|
| Rate for Payer: Healthscope Whirlpool |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Nomi Health Commercial |
$12.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.88
|
|
|
HC POC UREA NITROGEN
|
Facility
|
OP
|
$15.77
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$19.21 |
| Rate for Payer: Aetna Commercial |
$14.19
|
| Rate for Payer: Aetna Medicare |
$3.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: ASR ASR |
$15.30
|
| Rate for Payer: ASR Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$2.22
|
| Rate for Payer: BCBS MAPPO |
$3.95
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$12.23
|
| Rate for Payer: BCN Medicare Advantage |
$3.95
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
| Rate for Payer: Healthscope Commercial |
$15.77
|
| Rate for Payer: Healthscope Whirlpool |
$15.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.95
|
| Rate for Payer: Mclaren Commercial |
$14.19
|
| Rate for Payer: Mclaren Medicaid |
$2.12
|
| Rate for Payer: Mclaren Medicare |
$3.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: Meridian Medicaid |
$2.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Nomi Health Commercial |
$12.93
|
| Rate for Payer: PACE Medicare |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.95
|
| Rate for Payer: PHP Commercial |
$4.34
|
| Rate for Payer: PHP Medicaid |
$2.12
|
| Rate for Payer: PHP Medicare Advantage |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.21
|
| Rate for Payer: Priority Health Medicare |
$3.95
|
| Rate for Payer: Priority Health Narrow Network |
$15.37
|
| Rate for Payer: Railroad Medicare Medicare |
$3.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.95
|
| Rate for Payer: UHC Exchange |
$6.12
|
| Rate for Payer: UHC Medicare Advantage |
$3.95
|
| Rate for Payer: UHCCP DNSP |
$3.95
|
| Rate for Payer: UHCCP Medicaid |
$2.12
|
| Rate for Payer: VA VA |
$3.95
|
|
|
HC POC URINE PREG TEST
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.74
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC POC URINE PREG TEST
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$32.93 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.76
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.61
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$4.61
|
| Rate for Payer: Mclaren Medicare |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Medicare |
$8.18
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Commercial |
$9.47
|
| Rate for Payer: PHP Medicaid |
$4.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.93
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$26.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Exchange |
$13.35
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
| Rate for Payer: UHCCP DNSP |
$8.61
|
| Rate for Payer: UHCCP Medicaid |
$4.61
|
| Rate for Payer: VA VA |
$8.61
|
|
|
HC POC WET PREP
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600342
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$51.31 |
| Rate for Payer: Aetna Commercial |
$46.18
|
| Rate for Payer: Aetna Medicare |
$5.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.28
|
| Rate for Payer: ASR ASR |
$49.77
|
| Rate for Payer: ASR Commercial |
$49.77
|
| Rate for Payer: BCBS Complete |
$3.28
|
| Rate for Payer: BCBS MAPPO |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$42.02
|
| Rate for Payer: BCN Commercial |
$39.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.82
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.82
|
| Rate for Payer: Healthscope Commercial |
$51.31
|
| Rate for Payer: Healthscope Whirlpool |
$49.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.82
|
| Rate for Payer: Mclaren Commercial |
$46.18
|
| Rate for Payer: Mclaren Medicaid |
$3.12
|
| Rate for Payer: Mclaren Medicare |
$5.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.11
|
| Rate for Payer: Meridian Medicaid |
$3.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PACE Medicare |
$5.53
|
| Rate for Payer: PACE SWMI |
$5.82
|
| Rate for Payer: PHP Commercial |
$6.40
|
| Rate for Payer: PHP Medicaid |
$3.12
|
| Rate for Payer: PHP Medicare Advantage |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.33
|
| Rate for Payer: Priority Health Medicare |
$5.82
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$5.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.82
|
| Rate for Payer: UHC Exchange |
$9.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.82
|
| Rate for Payer: UHCCP DNSP |
$5.82
|
| Rate for Payer: UHCCP Medicaid |
$3.12
|
| Rate for Payer: VA VA |
$5.82
|
|
|
HC POC WET PREP
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600342
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.35 |
| Max. Negotiated Rate |
$51.31 |
| Rate for Payer: Aetna Commercial |
$46.18
|
| Rate for Payer: ASR ASR |
$49.77
|
| Rate for Payer: ASR Commercial |
$49.77
|
| Rate for Payer: BCBS Trust/PPO |
$41.81
|
| Rate for Payer: BCN Commercial |
$39.78
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$51.31
|
| Rate for Payer: Healthscope Whirlpool |
$49.77
|
| Rate for Payer: Mclaren Commercial |
$46.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.15
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
IP
|
$274.17
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.21 |
| Max. Negotiated Rate |
$274.17 |
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: ASR ASR |
$265.94
|
| Rate for Payer: ASR Commercial |
$265.94
|
| Rate for Payer: BCBS Trust/PPO |
$223.42
|
| Rate for Payer: BCN Commercial |
$212.56
|
| Rate for Payer: Cash Price |
$219.34
|
| Rate for Payer: Cofinity Commercial |
$257.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.34
|
| Rate for Payer: Healthscope Commercial |
$274.17
|
| Rate for Payer: Healthscope Whirlpool |
$265.94
|
| Rate for Payer: Mclaren Commercial |
$246.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.04
|
| Rate for Payer: Nomi Health Commercial |
$224.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.27
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
OP
|
$274.17
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.67 |
| Max. Negotiated Rate |
$274.17 |
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: Aetna Medicare |
$137.08
|
| Rate for Payer: ASR ASR |
$265.94
|
| Rate for Payer: ASR Commercial |
$265.94
|
| Rate for Payer: BCBS Complete |
$109.67
|
| Rate for Payer: BCBS Trust/PPO |
$224.52
|
| Rate for Payer: BCN Commercial |
$212.56
|
| Rate for Payer: Cash Price |
$219.34
|
| Rate for Payer: Cofinity Commercial |
$257.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.34
|
| Rate for Payer: Healthscope Commercial |
$274.17
|
| Rate for Payer: Healthscope Whirlpool |
$265.94
|
| Rate for Payer: Mclaren Commercial |
$246.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.04
|
| Rate for Payer: Nomi Health Commercial |
$224.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.23
|
| Rate for Payer: Priority Health Narrow Network |
$192.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.27
|
|
|
HC POLIOVIRUS VACCINE, INACTIVATED (IPV) SUBQ/IM
|
Facility
|
IP
|
$43.49
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
63600082
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.27 |
| Max. Negotiated Rate |
$43.49 |
| Rate for Payer: Aetna Commercial |
$39.14
|
| Rate for Payer: ASR ASR |
$42.19
|
| Rate for Payer: ASR Commercial |
$42.19
|
| Rate for Payer: BCBS Trust/PPO |
$35.44
|
| Rate for Payer: BCN Commercial |
$33.72
|
| Rate for Payer: Cash Price |
$34.79
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.79
|
| Rate for Payer: Healthscope Commercial |
$43.49
|
| Rate for Payer: Healthscope Whirlpool |
$42.19
|
| Rate for Payer: Mclaren Commercial |
$39.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.97
|
| Rate for Payer: Nomi Health Commercial |
$35.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.27
|
|
|
HC POLIOVIRUS VACCINE, INACTIVATED (IPV) SUBQ/IM
|
Facility
|
OP
|
$43.49
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
63600082
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$50.85 |
| Rate for Payer: Aetna Commercial |
$39.14
|
| Rate for Payer: Aetna Medicare |
$21.74
|
| Rate for Payer: ASR ASR |
$42.19
|
| Rate for Payer: ASR Commercial |
$42.19
|
| Rate for Payer: BCBS Complete |
$17.40
|
| Rate for Payer: BCBS Trust/PPO |
$35.61
|
| Rate for Payer: BCN Commercial |
$33.72
|
| Rate for Payer: Cash Price |
$34.79
|
| Rate for Payer: Cash Price |
$34.79
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.79
|
| Rate for Payer: Healthscope Commercial |
$43.49
|
| Rate for Payer: Healthscope Whirlpool |
$42.19
|
| Rate for Payer: Mclaren Commercial |
$39.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.97
|
| Rate for Payer: Nomi Health Commercial |
$35.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.85
|
| Rate for Payer: Priority Health Narrow Network |
$40.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.27
|
|
|
HC POLYPECTOMY
|
Facility
|
OP
|
$534.47
|
|
| Hospital Charge Code |
36000080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$213.79 |
| Max. Negotiated Rate |
$534.47 |
| Rate for Payer: Aetna Commercial |
$481.02
|
| Rate for Payer: Aetna Medicare |
$267.24
|
| Rate for Payer: ASR ASR |
$518.44
|
| Rate for Payer: ASR Commercial |
$518.44
|
| Rate for Payer: BCBS Complete |
$213.79
|
| Rate for Payer: BCBS Trust/PPO |
$437.68
|
| Rate for Payer: BCN Commercial |
$414.37
|
| Rate for Payer: Cash Price |
$427.58
|
| Rate for Payer: Cofinity Commercial |
$502.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.58
|
| Rate for Payer: Healthscope Commercial |
$534.47
|
| Rate for Payer: Healthscope Whirlpool |
$518.44
|
| Rate for Payer: Mclaren Commercial |
$481.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.30
|
| Rate for Payer: Nomi Health Commercial |
$438.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.30
|
| Rate for Payer: Priority Health Narrow Network |
$374.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.33
|
|
|
HC POLYPECTOMY
|
Facility
|
IP
|
$534.47
|
|
| Hospital Charge Code |
36000080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$347.41 |
| Max. Negotiated Rate |
$534.47 |
| Rate for Payer: Aetna Commercial |
$481.02
|
| Rate for Payer: ASR ASR |
$518.44
|
| Rate for Payer: ASR Commercial |
$518.44
|
| Rate for Payer: BCBS Trust/PPO |
$435.54
|
| Rate for Payer: BCN Commercial |
$414.37
|
| Rate for Payer: Cash Price |
$427.58
|
| Rate for Payer: Cofinity Commercial |
$502.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.58
|
| Rate for Payer: Healthscope Commercial |
$534.47
|
| Rate for Payer: Healthscope Whirlpool |
$518.44
|
| Rate for Payer: Mclaren Commercial |
$481.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.30
|
| Rate for Payer: Nomi Health Commercial |
$438.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.33
|
|
|
HC POLYPECTOMY ADDL 45 MIN OR MORE
|
Facility
|
OP
|
$182.73
|
|
| Hospital Charge Code |
36000004
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$73.09 |
| Max. Negotiated Rate |
$182.73 |
| Rate for Payer: Aetna Commercial |
$164.46
|
| Rate for Payer: Aetna Medicare |
$91.36
|
| Rate for Payer: ASR ASR |
$177.25
|
| Rate for Payer: ASR Commercial |
$177.25
|
| Rate for Payer: BCBS Complete |
$73.09
|
| Rate for Payer: BCBS Trust/PPO |
$149.64
|
| Rate for Payer: BCN Commercial |
$141.67
|
| Rate for Payer: Cash Price |
$146.18
|
| Rate for Payer: Cofinity Commercial |
$171.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.18
|
| Rate for Payer: Healthscope Commercial |
$182.73
|
| Rate for Payer: Healthscope Whirlpool |
$177.25
|
| Rate for Payer: Mclaren Commercial |
$164.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.32
|
| Rate for Payer: Nomi Health Commercial |
$149.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.11
|
| Rate for Payer: Priority Health Narrow Network |
$128.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.80
|
|
|
HC POLYPECTOMY ADDL 45 MIN OR MORE
|
Facility
|
IP
|
$182.73
|
|
| Hospital Charge Code |
36000004
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$118.77 |
| Max. Negotiated Rate |
$182.73 |
| Rate for Payer: Aetna Commercial |
$164.46
|
| Rate for Payer: ASR ASR |
$177.25
|
| Rate for Payer: ASR Commercial |
$177.25
|
| Rate for Payer: BCBS Trust/PPO |
$148.91
|
| Rate for Payer: BCN Commercial |
$141.67
|
| Rate for Payer: Cash Price |
$146.18
|
| Rate for Payer: Cofinity Commercial |
$171.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.18
|
| Rate for Payer: Healthscope Commercial |
$182.73
|
| Rate for Payer: Healthscope Whirlpool |
$177.25
|
| Rate for Payer: Mclaren Commercial |
$164.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.32
|
| Rate for Payer: Nomi Health Commercial |
$149.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.80
|
|
|
HC PORPHYRIN URINE QUANTITATIVE
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 84120
|
| Hospital Charge Code |
30100395
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: ASR Commercial |
$32.29
|
| Rate for Payer: BCBS Trust/PPO |
$27.13
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$33.29
|
| Rate for Payer: Healthscope Whirlpool |
$32.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC PORPHYRIN URINE QUANTITATIVE
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 84120
|
| Hospital Charge Code |
30100395
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$194.34 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$14.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.39
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: ASR Commercial |
$32.29
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$14.71
|
| Rate for Payer: BCBS Trust/PPO |
$27.26
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: BCN Medicare Advantage |
$14.71
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.71
|
| Rate for Payer: Healthscope Commercial |
$33.29
|
| Rate for Payer: Healthscope Whirlpool |
$32.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.71
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Mclaren Medicaid |
$7.88
|
| Rate for Payer: Mclaren Medicare |
$14.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.45
|
| Rate for Payer: Meridian Medicaid |
$8.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: PACE Medicare |
$13.97
|
| Rate for Payer: PACE SWMI |
$14.71
|
| Rate for Payer: PHP Commercial |
$16.18
|
| Rate for Payer: PHP Medicaid |
$7.88
|
| Rate for Payer: PHP Medicare Advantage |
$14.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.34
|
| Rate for Payer: Priority Health Medicare |
$14.71
|
| Rate for Payer: Priority Health Narrow Network |
$155.47
|
| Rate for Payer: Railroad Medicare Medicare |
$14.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.71
|
| Rate for Payer: UHC Exchange |
$22.80
|
| Rate for Payer: UHC Medicare Advantage |
$14.71
|
| Rate for Payer: UHCCP DNSP |
$14.71
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
| Rate for Payer: VA VA |
$14.71
|
|
|
HC PORPHYRIN URINE QUANTITATIVE C
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 84110
|
| Hospital Charge Code |
30100394
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$113.09 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.55
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: ASR Commercial |
$30.67
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.44
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$4.52
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.86
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PHP Commercial |
$9.28
|
| Rate for Payer: PHP Medicaid |
$4.52
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.09
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Narrow Network |
$90.47
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Exchange |
$13.08
|
| Rate for Payer: UHC Medicare Advantage |
$8.44
|
| Rate for Payer: UHCCP DNSP |
$8.44
|
| Rate for Payer: UHCCP Medicaid |
$4.52
|
| Rate for Payer: VA VA |
$8.44
|
|
|
HC PORPHYRIN URINE QUANTITATIVE C
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 84110
|
| Hospital Charge Code |
30100394
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: ASR Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$25.77
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
