|
HC PPM SINGLE/V LEAD
|
Facility
|
IP
|
$13,060.39
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
36100058
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,489.25 |
| Max. Negotiated Rate |
$13,060.39 |
| Rate for Payer: Aetna Commercial |
$11,754.35
|
| Rate for Payer: ASR ASR |
$12,668.58
|
| Rate for Payer: ASR Commercial |
$12,668.58
|
| Rate for Payer: BCBS Trust/PPO |
$10,642.91
|
| Rate for Payer: BCN Commercial |
$10,125.72
|
| Rate for Payer: Cash Price |
$10,448.31
|
| Rate for Payer: Cofinity Commercial |
$12,276.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,448.31
|
| Rate for Payer: Healthscope Commercial |
$13,060.39
|
| Rate for Payer: Healthscope Whirlpool |
$12,668.58
|
| Rate for Payer: Mclaren Commercial |
$11,754.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,101.33
|
| Rate for Payer: Nomi Health Commercial |
$10,709.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,489.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,493.14
|
|
|
HC PPM SINGLE/V LEAD
|
Facility
|
OP
|
$13,060.39
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
36100058
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,495.99 |
| Max. Negotiated Rate |
$15,893.27 |
| Rate for Payer: Aetna Commercial |
$11,754.35
|
| Rate for Payer: Aetna Medicare |
$10,253.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,817.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,817.15
|
| Rate for Payer: ASR ASR |
$12,668.58
|
| Rate for Payer: ASR Commercial |
$12,668.58
|
| Rate for Payer: BCBS Complete |
$5,770.79
|
| Rate for Payer: BCBS MAPPO |
$10,253.72
|
| Rate for Payer: BCBS Trust/PPO |
$10,695.15
|
| Rate for Payer: BCN Commercial |
$10,125.72
|
| Rate for Payer: BCN Medicare Advantage |
$10,253.72
|
| Rate for Payer: Cash Price |
$10,448.31
|
| Rate for Payer: Cash Price |
$10,448.31
|
| Rate for Payer: Cofinity Commercial |
$12,276.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,448.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,253.72
|
| Rate for Payer: Healthscope Commercial |
$13,060.39
|
| Rate for Payer: Healthscope Whirlpool |
$12,668.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,253.72
|
| Rate for Payer: Mclaren Commercial |
$11,754.35
|
| Rate for Payer: Mclaren Medicaid |
$5,495.99
|
| Rate for Payer: Mclaren Medicare |
$10,253.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,766.41
|
| Rate for Payer: Meridian Medicaid |
$5,770.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,791.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,101.33
|
| Rate for Payer: Nomi Health Commercial |
$10,709.52
|
| Rate for Payer: PACE Medicare |
$9,741.03
|
| Rate for Payer: PACE SWMI |
$10,253.72
|
| Rate for Payer: PHP Commercial |
$11,279.09
|
| Rate for Payer: PHP Medicaid |
$5,495.99
|
| Rate for Payer: PHP Medicare Advantage |
$10,253.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,495.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,489.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,443.51
|
| Rate for Payer: Priority Health Medicare |
$10,253.72
|
| Rate for Payer: Priority Health Narrow Network |
$9,155.33
|
| Rate for Payer: Railroad Medicare Medicare |
$10,253.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,493.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,253.72
|
| Rate for Payer: UHC Exchange |
$15,893.27
|
| Rate for Payer: UHC Medicare Advantage |
$10,253.72
|
| Rate for Payer: UHCCP DNSP |
$10,253.72
|
| Rate for Payer: UHCCP Medicaid |
$5,495.99
|
| Rate for Payer: VA VA |
$10,253.72
|
|
|
HC PPU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200007
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC PPU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200007
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC PRADER WILLI MOL ANALYSIS
|
Facility
|
IP
|
$438.60
|
|
|
Service Code
|
CPT 81331
|
| Hospital Charge Code |
31000103
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$285.09 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: ASR Commercial |
$425.44
|
| Rate for Payer: BCBS Trust/PPO |
$357.42
|
| Rate for Payer: BCN Commercial |
$340.05
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$412.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$438.60
|
| Rate for Payer: Healthscope Whirlpool |
$425.44
|
| Rate for Payer: Mclaren Commercial |
$394.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
|
|
HC PRADER WILLI MOL ANALYSIS
|
Facility
|
OP
|
$438.60
|
|
|
Service Code
|
CPT 81331
|
| Hospital Charge Code |
31000103
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: Aetna Medicare |
$51.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.84
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: ASR Commercial |
$425.44
|
| Rate for Payer: BCBS Complete |
$28.74
|
| Rate for Payer: BCBS MAPPO |
$51.07
|
| Rate for Payer: BCBS Trust/PPO |
$359.17
|
| Rate for Payer: BCN Commercial |
$340.05
|
| Rate for Payer: BCN Medicare Advantage |
$51.07
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$412.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.07
|
| Rate for Payer: Healthscope Commercial |
$438.60
|
| Rate for Payer: Healthscope Whirlpool |
$425.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.07
|
| Rate for Payer: Mclaren Commercial |
$394.74
|
| Rate for Payer: Mclaren Medicaid |
$27.37
|
| Rate for Payer: Mclaren Medicare |
$51.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.62
|
| Rate for Payer: Meridian Medicaid |
$28.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: PACE Medicare |
$48.52
|
| Rate for Payer: PACE SWMI |
$51.07
|
| Rate for Payer: PHP Commercial |
$56.18
|
| Rate for Payer: PHP Medicaid |
$27.37
|
| Rate for Payer: PHP Medicare Advantage |
$51.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.46
|
| Rate for Payer: Priority Health Medicare |
$51.07
|
| Rate for Payer: Priority Health Narrow Network |
$49.17
|
| Rate for Payer: Railroad Medicare Medicare |
$51.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.07
|
| Rate for Payer: UHC Exchange |
$79.16
|
| Rate for Payer: UHC Medicare Advantage |
$51.07
|
| Rate for Payer: UHCCP DNSP |
$51.07
|
| Rate for Payer: UHCCP Medicaid |
$27.37
|
| Rate for Payer: VA VA |
$51.07
|
|
|
HC PREALBUMIN
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
30100398
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.08 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: ASR ASR |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.52
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
|
|
HC PREALBUMIN
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
30100398
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.24
|
| Rate for Payer: ASR ASR |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Complete |
$8.21
|
| Rate for Payer: BCBS MAPPO |
$14.59
|
| Rate for Payer: BCBS Trust/PPO |
$56.80
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: BCN Medicare Advantage |
$14.59
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.59
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$7.82
|
| Rate for Payer: Mclaren Medicare |
$14.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.32
|
| Rate for Payer: Meridian Medicaid |
$8.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: PACE Medicare |
$13.86
|
| Rate for Payer: PACE SWMI |
$14.59
|
| Rate for Payer: PHP Commercial |
$16.05
|
| Rate for Payer: PHP Medicaid |
$7.82
|
| Rate for Payer: PHP Medicare Advantage |
$14.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.54
|
| Rate for Payer: Priority Health Medicare |
$14.59
|
| Rate for Payer: Priority Health Narrow Network |
$31.63
|
| Rate for Payer: Railroad Medicare Medicare |
$14.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.59
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Medicare Advantage |
$14.59
|
| Rate for Payer: UHCCP DNSP |
$14.59
|
| Rate for Payer: UHCCP Medicaid |
$7.82
|
| Rate for Payer: VA VA |
$14.59
|
|
|
HC PREGNANCY TEST SERUM
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
30100467
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.43
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC PREGNANCY TEST SERUM
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
30100467
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$32.93 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$7.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.40
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Complete |
$4.23
|
| Rate for Payer: BCBS MAPPO |
$7.52
|
| Rate for Payer: BCBS Trust/PPO |
$25.56
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: BCN Medicare Advantage |
$7.52
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.52
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.52
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$4.03
|
| Rate for Payer: Mclaren Medicare |
$7.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.90
|
| Rate for Payer: Meridian Medicaid |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Medicare |
$7.14
|
| Rate for Payer: PACE SWMI |
$7.52
|
| Rate for Payer: PHP Commercial |
$8.27
|
| Rate for Payer: PHP Medicaid |
$4.03
|
| Rate for Payer: PHP Medicare Advantage |
$7.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.93
|
| Rate for Payer: Priority Health Medicare |
$7.52
|
| Rate for Payer: Priority Health Narrow Network |
$26.34
|
| Rate for Payer: Railroad Medicare Medicare |
$7.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.52
|
| Rate for Payer: UHC Exchange |
$11.66
|
| Rate for Payer: UHC Medicare Advantage |
$7.52
|
| Rate for Payer: UHCCP DNSP |
$7.52
|
| Rate for Payer: UHCCP Medicaid |
$4.03
|
| Rate for Payer: VA VA |
$7.52
|
|
|
HC PREGNENOLONE
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 84140
|
| Hospital Charge Code |
30100561
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$20.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.84
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$20.67
|
| Rate for Payer: BCBS Trust/PPO |
$75.18
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: BCN Medicare Advantage |
$20.67
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.67
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.67
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Mclaren Medicare |
$20.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.70
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Medicare |
$19.64
|
| Rate for Payer: PACE SWMI |
$20.67
|
| Rate for Payer: PHP Commercial |
$22.74
|
| Rate for Payer: PHP Medicaid |
$11.08
|
| Rate for Payer: PHP Medicare Advantage |
$20.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.44
|
| Rate for Payer: Priority Health Medicare |
$20.67
|
| Rate for Payer: Priority Health Narrow Network |
$64.35
|
| Rate for Payer: Railroad Medicare Medicare |
$20.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.67
|
| Rate for Payer: UHC Exchange |
$32.04
|
| Rate for Payer: UHC Medicare Advantage |
$20.67
|
| Rate for Payer: UHCCP DNSP |
$20.67
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$20.67
|
|
|
HC PREGNENOLONE
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 84140
|
| Hospital Charge Code |
30100561
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$74.81
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC PRENATAL ANEUPLOIDY DETECTION, FISH
|
Facility
|
IP
|
$96.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000130
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$96.76 |
| Rate for Payer: Aetna Commercial |
$87.08
|
| Rate for Payer: ASR ASR |
$93.86
|
| Rate for Payer: ASR Commercial |
$93.86
|
| Rate for Payer: BCBS Trust/PPO |
$78.85
|
| Rate for Payer: BCN Commercial |
$75.02
|
| Rate for Payer: Cash Price |
$77.41
|
| Rate for Payer: Cofinity Commercial |
$90.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.41
|
| Rate for Payer: Healthscope Commercial |
$96.76
|
| Rate for Payer: Healthscope Whirlpool |
$93.86
|
| Rate for Payer: Mclaren Commercial |
$87.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.25
|
| Rate for Payer: Nomi Health Commercial |
$79.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.15
|
|
|
HC PRENATAL ANEUPLOIDY DETECTION, FISH
|
Facility
|
OP
|
$96.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000130
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$96.76 |
| Rate for Payer: Aetna Commercial |
$87.08
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$93.86
|
| Rate for Payer: ASR Commercial |
$93.86
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$79.24
|
| Rate for Payer: BCN Commercial |
$75.02
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$77.41
|
| Rate for Payer: Cash Price |
$77.41
|
| Rate for Payer: Cofinity Commercial |
$90.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$96.76
|
| Rate for Payer: Healthscope Whirlpool |
$93.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$87.08
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.25
|
| Rate for Payer: Nomi Health Commercial |
$79.34
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.78
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$67.83
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.99 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: ASR ASR |
$182.05
|
| Rate for Payer: ASR Commercial |
$182.05
|
| Rate for Payer: BCBS Trust/PPO |
$152.94
|
| Rate for Payer: BCN Commercial |
$145.51
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$176.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$187.68
|
| Rate for Payer: Healthscope Whirlpool |
$182.05
|
| Rate for Payer: Mclaren Commercial |
$168.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.16
|
|
|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$182.05
|
| Rate for Payer: ASR Commercial |
$182.05
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$153.69
|
| Rate for Payer: BCN Commercial |
$145.51
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$176.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$187.68
|
| Rate for Payer: Healthscope Whirlpool |
$182.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$168.91
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$16.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP DNSP |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.68
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: ASR Commercial |
$68.63
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$57.94
|
| Rate for Payer: BCN Commercial |
$54.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$70.75
|
| Rate for Payer: Healthscope Whirlpool |
$68.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$63.68
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.99
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$49.60
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Aetna Commercial |
$63.68
|
| Rate for Payer: ASR ASR |
$68.63
|
| Rate for Payer: ASR Commercial |
$68.63
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCN Commercial |
$54.85
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$66.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$70.75
|
| Rate for Payer: Healthscope Whirlpool |
$68.63
|
| Rate for Payer: Mclaren Commercial |
$63.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.26
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
OP
|
$1,496.73
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,496.73 |
| Rate for Payer: Aetna Commercial |
$1,347.06
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,451.83
|
| Rate for Payer: ASR Commercial |
$1,451.83
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.67
|
| Rate for Payer: BCN Commercial |
$1,160.41
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,197.38
|
| Rate for Payer: Cash Price |
$1,197.38
|
| Rate for Payer: Cofinity Commercial |
$1,406.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,197.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,496.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,451.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,347.06
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.22
|
| Rate for Payer: Nomi Health Commercial |
$1,227.32
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.77
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$213.42
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,317.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
IP
|
$1,496.73
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$972.87 |
| Max. Negotiated Rate |
$1,496.73 |
| Rate for Payer: Aetna Commercial |
$1,347.06
|
| Rate for Payer: ASR ASR |
$1,451.83
|
| Rate for Payer: ASR Commercial |
$1,451.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,219.69
|
| Rate for Payer: BCN Commercial |
$1,160.41
|
| Rate for Payer: Cash Price |
$1,197.38
|
| Rate for Payer: Cofinity Commercial |
$1,406.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,197.38
|
| Rate for Payer: Healthscope Commercial |
$1,496.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,451.83
|
| Rate for Payer: Mclaren Commercial |
$1,347.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.22
|
| Rate for Payer: Nomi Health Commercial |
$1,227.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,317.12
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$710.50
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.30
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$102.64
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Trust/PPO |
$707.03
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
IP
|
$1,020.00
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Aetna Commercial |
$918.00
|
| Rate for Payer: ASR ASR |
$989.40
|
| Rate for Payer: ASR Commercial |
$989.40
|
| Rate for Payer: BCBS Trust/PPO |
$831.20
|
| Rate for Payer: BCN Commercial |
$790.81
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$958.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.00
|
| Rate for Payer: Healthscope Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Whirlpool |
$989.40
|
| Rate for Payer: Mclaren Commercial |
$918.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.00
|
| Rate for Payer: Nomi Health Commercial |
$836.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$897.60
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
OP
|
$1,020.00
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.47 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Aetna Commercial |
$918.00
|
| Rate for Payer: Aetna Medicare |
$599.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: ASR ASR |
$989.40
|
| Rate for Payer: ASR Commercial |
$989.40
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$835.28
|
| Rate for Payer: BCN Commercial |
$790.81
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$958.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Whirlpool |
$989.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$599.75
|
| Rate for Payer: Mclaren Commercial |
$918.00
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.00
|
| Rate for Payer: Nomi Health Commercial |
$836.40
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$659.72
|
| Rate for Payer: PHP Medicaid |
$321.47
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$893.72
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$715.02
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$897.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$929.61
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP DNSP |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC PRESSURE WIRE
|
Facility
|
OP
|
$2,201.25
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$880.50 |
| Max. Negotiated Rate |
$2,201.25 |
| Rate for Payer: Aetna Commercial |
$1,981.12
|
| Rate for Payer: Aetna Medicare |
$1,100.62
|
| Rate for Payer: ASR ASR |
$2,135.21
|
| Rate for Payer: ASR Commercial |
$2,135.21
|
| Rate for Payer: BCBS Complete |
$880.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,802.60
|
| Rate for Payer: BCN Commercial |
$1,706.63
|
| Rate for Payer: Cash Price |
$1,761.00
|
| Rate for Payer: Cofinity Commercial |
$2,069.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.00
|
| Rate for Payer: Healthscope Commercial |
$2,201.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,135.21
|
| Rate for Payer: Mclaren Commercial |
$1,981.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.06
|
| Rate for Payer: Nomi Health Commercial |
$1,805.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,928.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,543.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,937.10
|
|
