|
HC PRESSURE WIRE
|
Facility
|
IP
|
$2,201.25
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,430.81 |
| Max. Negotiated Rate |
$2,201.25 |
| Rate for Payer: Aetna Commercial |
$1,981.12
|
| Rate for Payer: ASR ASR |
$2,135.21
|
| Rate for Payer: ASR Commercial |
$2,135.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.80
|
| 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: UHC All Payor (Choice/PPO) + Core |
$1,937.10
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$85.20
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.16
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$72.93
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
IP
|
$51.50
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.48 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$46.35
|
| Rate for Payer: ASR ASR |
$49.96
|
| Rate for Payer: ASR Commercial |
$49.96
|
| Rate for Payer: BCBS Trust/PPO |
$41.97
|
| Rate for Payer: BCN Commercial |
$39.93
|
| Rate for Payer: Cash Price |
$41.20
|
| Rate for Payer: Cofinity Commercial |
$48.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.20
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Healthscope Whirlpool |
$49.96
|
| Rate for Payer: Mclaren Commercial |
$46.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.78
|
| Rate for Payer: Nomi Health Commercial |
$42.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.32
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
OP
|
$51.50
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$46.35
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$49.96
|
| Rate for Payer: ASR Commercial |
$49.96
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$42.17
|
| Rate for Payer: BCN Commercial |
$39.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$41.20
|
| Rate for Payer: Cash Price |
$41.20
|
| Rate for Payer: Cofinity Commercial |
$48.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Healthscope Whirlpool |
$49.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$46.35
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.78
|
| Rate for Payer: Nomi Health Commercial |
$42.23
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.12
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$36.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$211.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$312.93 |
| Rate for Payer: Aetna Commercial |
$190.03
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$204.81
|
| Rate for Payer: ASR Commercial |
$204.81
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$172.90
|
| Rate for Payer: BCN Commercial |
$163.70
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$198.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$211.14
|
| Rate for Payer: Healthscope Whirlpool |
$204.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$190.03
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.47
|
| Rate for Payer: Nomi Health Commercial |
$173.13
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.93
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$250.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
IP
|
$211.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$137.24 |
| Max. Negotiated Rate |
$211.14 |
| Rate for Payer: Aetna Commercial |
$190.03
|
| Rate for Payer: ASR ASR |
$204.81
|
| Rate for Payer: ASR Commercial |
$204.81
|
| Rate for Payer: BCBS Trust/PPO |
$172.06
|
| Rate for Payer: BCN Commercial |
$163.70
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$198.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.91
|
| Rate for Payer: Healthscope Commercial |
$211.14
|
| Rate for Payer: Healthscope Whirlpool |
$204.81
|
| Rate for Payer: Mclaren Commercial |
$190.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.47
|
| Rate for Payer: Nomi Health Commercial |
$173.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.80
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$27.05
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.58 |
| Max. Negotiated Rate |
$27.05 |
| Rate for Payer: Aetna Commercial |
$24.34
|
| Rate for Payer: ASR ASR |
$26.24
|
| Rate for Payer: ASR Commercial |
$26.24
|
| Rate for Payer: BCBS Trust/PPO |
$22.04
|
| Rate for Payer: BCN Commercial |
$20.97
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$25.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$27.05
|
| Rate for Payer: Healthscope Whirlpool |
$26.24
|
| Rate for Payer: Mclaren Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.80
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$27.05
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$85.10 |
| Rate for Payer: Aetna Commercial |
$24.34
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: ASR ASR |
$26.24
|
| Rate for Payer: ASR Commercial |
$26.24
|
| Rate for Payer: BCBS Complete |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$22.15
|
| Rate for Payer: BCN Commercial |
$20.97
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$25.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$27.05
|
| Rate for Payer: Healthscope Whirlpool |
$26.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$24.34
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicaid |
$8.20
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.10
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$68.08
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$23.72
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP DNSP |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$8.20
|
| Rate for Payer: VA VA |
$15.30
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$98.81 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare |
$16.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.74
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$31.52
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$16.59
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.59
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Mclaren Medicare |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.42
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PACE Medicare |
$15.76
|
| Rate for Payer: PACE SWMI |
$16.59
|
| Rate for Payer: PHP Commercial |
$18.25
|
| Rate for Payer: PHP Medicaid |
$8.89
|
| Rate for Payer: PHP Medicare Advantage |
$16.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.81
|
| Rate for Payer: Priority Health Medicare |
$16.59
|
| Rate for Payer: Priority Health Narrow Network |
$79.05
|
| Rate for Payer: Railroad Medicare Medicare |
$16.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.59
|
| Rate for Payer: UHC Exchange |
$25.71
|
| Rate for Payer: UHC Medicare Advantage |
$16.59
|
| Rate for Payer: UHCCP DNSP |
$16.59
|
| Rate for Payer: UHCCP Medicaid |
$8.89
|
| Rate for Payer: VA VA |
$16.59
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$38.49 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Trust/PPO |
$31.37
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$164.42 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna Commercial |
$227.66
|
| Rate for Payer: ASR ASR |
$245.37
|
| Rate for Payer: ASR Commercial |
$245.37
|
| Rate for Payer: BCBS Trust/PPO |
$206.14
|
| Rate for Payer: BCN Commercial |
$196.12
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$237.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Healthscope Whirlpool |
$245.37
|
| Rate for Payer: Mclaren Commercial |
$227.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.60
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.58 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna Commercial |
$227.66
|
| Rate for Payer: Aetna Medicare |
$90.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: ASR ASR |
$245.37
|
| Rate for Payer: ASR Commercial |
$245.37
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$207.15
|
| Rate for Payer: BCN Commercial |
$196.12
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$237.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Healthscope Whirlpool |
$245.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.63
|
| Rate for Payer: Mclaren Commercial |
$227.66
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$99.69
|
| Rate for Payer: PHP Medicaid |
$48.58
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.64
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$177.32
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$140.48
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP DNSP |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: VA VA |
$90.63
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$193.80
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.52 |
| Max. Negotiated Rate |
$193.80 |
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: Aetna Medicare |
$96.90
|
| Rate for Payer: ASR ASR |
$187.99
|
| Rate for Payer: ASR Commercial |
$187.99
|
| Rate for Payer: BCBS Complete |
$77.52
|
| Rate for Payer: BCBS Trust/PPO |
$158.70
|
| Rate for Payer: BCN Commercial |
$150.25
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$182.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$193.80
|
| Rate for Payer: Healthscope Whirlpool |
$187.99
|
| Rate for Payer: Mclaren Commercial |
$174.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.81
|
| Rate for Payer: Priority Health Narrow Network |
$135.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.54
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$193.80
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.97 |
| Max. Negotiated Rate |
$193.80 |
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: ASR ASR |
$187.99
|
| Rate for Payer: ASR Commercial |
$187.99
|
| Rate for Payer: BCBS Trust/PPO |
$157.93
|
| Rate for Payer: BCN Commercial |
$150.25
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$182.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$193.80
|
| Rate for Payer: Healthscope Whirlpool |
$187.99
|
| Rate for Payer: Mclaren Commercial |
$174.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.54
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$154.22
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.04 |
| Max. Negotiated Rate |
$213.00 |
| Rate for Payer: Aetna Commercial |
$138.80
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: ASR ASR |
$149.59
|
| Rate for Payer: ASR Commercial |
$149.59
|
| Rate for Payer: BCBS Complete |
$22.10
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$126.29
|
| Rate for Payer: BCN Commercial |
$119.57
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Healthscope Whirlpool |
$149.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$39.26
|
| Rate for Payer: Mclaren Commercial |
$138.80
|
| Rate for Payer: Mclaren Medicaid |
$21.04
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$22.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$43.19
|
| Rate for Payer: PHP Medicaid |
$21.04
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.00
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$170.40
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.26
|
| Rate for Payer: UHC Exchange |
$60.85
|
| Rate for Payer: UHC Medicare Advantage |
$39.26
|
| Rate for Payer: UHCCP DNSP |
$39.26
|
| Rate for Payer: UHCCP Medicaid |
$21.04
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC PRO BNP
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.24 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$138.80
|
| Rate for Payer: ASR ASR |
$149.59
|
| Rate for Payer: ASR Commercial |
$149.59
|
| Rate for Payer: BCBS Trust/PPO |
$125.67
|
| Rate for Payer: BCN Commercial |
$119.57
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Healthscope Whirlpool |
$149.59
|
| Rate for Payer: Mclaren Commercial |
$138.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.71
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
OP
|
$68.34
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna Medicare |
$16.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.94
|
| Rate for Payer: ASR ASR |
$66.29
|
| Rate for Payer: ASR Commercial |
$66.29
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$16.75
|
| Rate for Payer: BCBS Trust/PPO |
$55.96
|
| Rate for Payer: BCN Commercial |
$52.98
|
| Rate for Payer: BCN Medicare Advantage |
$16.75
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$68.34
|
| Rate for Payer: Healthscope Whirlpool |
$66.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.75
|
| Rate for Payer: Mclaren Commercial |
$61.51
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Mclaren Medicare |
$16.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.59
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PACE Medicare |
$15.91
|
| Rate for Payer: PACE SWMI |
$16.75
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: PHP Medicaid |
$8.98
|
| Rate for Payer: PHP Medicare Advantage |
$16.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.88
|
| Rate for Payer: Priority Health Medicare |
$16.75
|
| Rate for Payer: Priority Health Narrow Network |
$47.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.75
|
| Rate for Payer: UHC Exchange |
$25.96
|
| Rate for Payer: UHC Medicare Advantage |
$16.75
|
| Rate for Payer: UHCCP DNSP |
$16.75
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$16.75
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
IP
|
$68.34
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: ASR ASR |
$66.29
|
| Rate for Payer: ASR Commercial |
$66.29
|
| Rate for Payer: BCBS Trust/PPO |
$55.69
|
| Rate for Payer: BCN Commercial |
$52.98
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$68.34
|
| Rate for Payer: Healthscope Whirlpool |
$66.29
|
| Rate for Payer: Mclaren Commercial |
$61.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.14
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,423.93
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$7,423.93 |
| Rate for Payer: Aetna Commercial |
$6,681.54
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$7,201.21
|
| Rate for Payer: ASR Commercial |
$7,201.21
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,079.46
|
| Rate for Payer: BCN Commercial |
$5,755.77
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$6,978.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$7,423.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,201.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$6,681.54
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: Nomi Health Commercial |
$6,087.62
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.99
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$134.39
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,533.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
IP
|
$7,423.93
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,825.55 |
| Max. Negotiated Rate |
$7,423.93 |
| Rate for Payer: Aetna Commercial |
$6,681.54
|
| Rate for Payer: ASR ASR |
$7,201.21
|
| Rate for Payer: ASR Commercial |
$7,201.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,049.76
|
| Rate for Payer: BCN Commercial |
$5,755.77
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$6,978.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Healthscope Commercial |
$7,423.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,201.21
|
| Rate for Payer: Mclaren Commercial |
$6,681.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: Nomi Health Commercial |
$6,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,533.06
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.59 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$27.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.02
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Complete |
$15.32
|
| Rate for Payer: BCBS MAPPO |
$27.22
|
| Rate for Payer: BCBS Trust/PPO |
$85.20
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.22
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.22
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$27.22
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$14.59
|
| Rate for Payer: Mclaren Medicare |
$27.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.58
|
| Rate for Payer: Meridian Medicaid |
$15.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Medicare |
$25.86
|
| Rate for Payer: PACE SWMI |
$27.22
|
| Rate for Payer: PHP Commercial |
$29.94
|
| Rate for Payer: PHP Medicaid |
$14.59
|
| Rate for Payer: PHP Medicare Advantage |
$27.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.16
|
| Rate for Payer: Priority Health Medicare |
$27.22
|
| Rate for Payer: Priority Health Narrow Network |
$72.93
|
| Rate for Payer: Railroad Medicare Medicare |
$27.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.22
|
| Rate for Payer: UHC Exchange |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$27.22
|
| Rate for Payer: UHCCP DNSP |
$27.22
|
| Rate for Payer: UHCCP Medicaid |
$14.59
|
| Rate for Payer: VA VA |
$27.22
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
|
|
HC PROCESS FEE
|
Facility
|
IP
|
$36.72
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.87 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$33.05
|
| Rate for Payer: ASR ASR |
$35.62
|
| Rate for Payer: ASR Commercial |
$35.62
|
| Rate for Payer: BCBS Trust/PPO |
$29.92
|
| Rate for Payer: BCN Commercial |
$28.47
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$34.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Healthscope Whirlpool |
$35.62
|
| Rate for Payer: Mclaren Commercial |
$33.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.21
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.31
|
|
|
HC PROCESS FEE
|
Facility
|
OP
|
$36.72
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$33.05
|
| Rate for Payer: Aetna Medicare |
$18.36
|
| Rate for Payer: ASR ASR |
$35.62
|
| Rate for Payer: ASR Commercial |
$35.62
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS Trust/PPO |
$30.07
|
| Rate for Payer: BCN Commercial |
$28.47
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$34.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Healthscope Whirlpool |
$35.62
|
| Rate for Payer: Mclaren Commercial |
$33.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.21
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.17
|
| Rate for Payer: Priority Health Narrow Network |
$25.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.31
|
|
