|
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
|
OP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna Commercial |
$227.66
|
| Rate for Payer: Aetna Medicare |
$90.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.76
|
| Rate for Payer: ASR ASR |
$245.37
|
| Rate for Payer: ASR Commercial |
$245.37
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCBS Trust/PPO |
$207.15
|
| Rate for Payer: BCN Commercial |
$196.12
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| 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 |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Healthscope Whirlpool |
$245.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.21
|
| Rate for Payer: Mclaren Commercial |
$227.66
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Mclaren Medicare |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.72
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PACE Medicare |
$85.70
|
| Rate for Payer: PACE SWMI |
$90.21
|
| Rate for Payer: PHP Commercial |
$99.23
|
| Rate for Payer: PHP Medicaid |
$48.35
|
| Rate for Payer: PHP Medicare Advantage |
$90.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| 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 |
$90.21
|
| Rate for Payer: Priority Health Narrow Network |
$177.32
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.21
|
| Rate for Payer: UHC Exchange |
$139.83
|
| Rate for Payer: UHC Medicare Advantage |
$90.21
|
| Rate for Payer: UHCCP DNSP |
$90.21
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: VA VA |
$90.21
|
|
|
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 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 |
$154.22 |
| 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 |
$135.13
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$108.11
|
| 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 |
$18.43
|
| 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
|
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 PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,423.93
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$7,423.93 |
| Rate for Payer: Aetna Commercial |
$6,681.54
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$7,201.21
|
| Rate for Payer: ASR Commercial |
$7,201.21
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,079.46
|
| Rate for Payer: BCN Commercial |
$5,755.77
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| 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 |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$7,423.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,201.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$6,681.54
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| 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 |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,504.85
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$5,204.17
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,533.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
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 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 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
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
OP
|
$1,162.48
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$476.60 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$1,046.23
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$1,127.61
|
| Rate for Payer: ASR Commercial |
$1,127.61
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$951.95
|
| Rate for Payer: BCN Commercial |
$901.27
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$1,092.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$1,162.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$1,046.23
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,018.56
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$814.90
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
IP
|
$1,162.48
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$755.61 |
| Max. Negotiated Rate |
$1,162.48 |
| Rate for Payer: Aetna Commercial |
$1,046.23
|
| Rate for Payer: ASR ASR |
$1,127.61
|
| Rate for Payer: ASR Commercial |
$1,127.61
|
| Rate for Payer: BCBS Trust/PPO |
$947.30
|
| Rate for Payer: BCN Commercial |
$901.27
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$1,092.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Healthscope Commercial |
$1,162.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.61
|
| Rate for Payer: Mclaren Commercial |
$1,046.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.98
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
OP
|
$38.54
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.12 |
| Max. Negotiated Rate |
$69.75 |
| Rate for Payer: Aetna Commercial |
$34.69
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: ASR ASR |
$37.38
|
| Rate for Payer: ASR Commercial |
$37.38
|
| Rate for Payer: BCBS Complete |
$25.33
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$36.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$38.54
|
| Rate for Payer: Healthscope Whirlpool |
$37.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$45.00
|
| Rate for Payer: Mclaren Commercial |
$34.69
|
| Rate for Payer: Mclaren Medicaid |
$24.12
|
| Rate for Payer: Mclaren Medicare |
$45.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: Meridian Medicaid |
$25.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: PACE Medicare |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Medicaid |
$24.12
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.77
|
| Rate for Payer: Priority Health Medicare |
$45.00
|
| Rate for Payer: Priority Health Narrow Network |
$27.02
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.00
|
| Rate for Payer: UHC Exchange |
$69.75
|
| Rate for Payer: UHC Medicare Advantage |
$45.00
|
| Rate for Payer: UHCCP DNSP |
$45.00
|
| Rate for Payer: UHCCP Medicaid |
$24.12
|
| Rate for Payer: VA VA |
$45.00
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
IP
|
$38.54
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$38.54 |
| Rate for Payer: Aetna Commercial |
$34.69
|
| Rate for Payer: ASR ASR |
$37.38
|
| Rate for Payer: ASR Commercial |
$37.38
|
| Rate for Payer: BCBS Trust/PPO |
$31.41
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$36.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Healthscope Commercial |
$38.54
|
| Rate for Payer: Healthscope Whirlpool |
$37.38
|
| Rate for Payer: Mclaren Commercial |
$34.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.92
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
OP
|
$38.54
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.12 |
| Max. Negotiated Rate |
$69.75 |
| Rate for Payer: Aetna Commercial |
$34.69
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: ASR ASR |
$37.38
|
| Rate for Payer: ASR Commercial |
$37.38
|
| Rate for Payer: BCBS Complete |
$25.33
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$36.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$38.54
|
| Rate for Payer: Healthscope Whirlpool |
$37.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$45.00
|
| Rate for Payer: Mclaren Commercial |
$34.69
|
| Rate for Payer: Mclaren Medicaid |
$24.12
|
| Rate for Payer: Mclaren Medicare |
$45.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: Meridian Medicaid |
$25.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: PACE Medicare |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Medicaid |
$24.12
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.77
|
| Rate for Payer: Priority Health Medicare |
$45.00
|
| Rate for Payer: Priority Health Narrow Network |
$27.02
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.00
|
| Rate for Payer: UHC Exchange |
$69.75
|
| Rate for Payer: UHC Medicare Advantage |
$45.00
|
| Rate for Payer: UHCCP DNSP |
$45.00
|
| Rate for Payer: UHCCP Medicaid |
$24.12
|
| Rate for Payer: VA VA |
$45.00
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
IP
|
$38.54
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$38.54 |
| Rate for Payer: Aetna Commercial |
$34.69
|
| Rate for Payer: ASR ASR |
$37.38
|
| Rate for Payer: ASR Commercial |
$37.38
|
| Rate for Payer: BCBS Trust/PPO |
$31.41
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$36.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Healthscope Commercial |
$38.54
|
| Rate for Payer: Healthscope Whirlpool |
$37.38
|
| Rate for Payer: Mclaren Commercial |
$34.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.92
|
|
|
HC PROGESTERONE LEVEL
|
Facility
|
IP
|
$78.51
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
30100400
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.03 |
| Max. Negotiated Rate |
$78.51 |
| Rate for Payer: Aetna Commercial |
$70.66
|
| Rate for Payer: ASR ASR |
$76.15
|
| Rate for Payer: ASR Commercial |
$76.15
|
| Rate for Payer: BCBS Trust/PPO |
$63.98
|
| Rate for Payer: BCN Commercial |
$60.87
|
| Rate for Payer: Cash Price |
$62.81
|
| Rate for Payer: Cofinity Commercial |
$73.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.81
|
| Rate for Payer: Healthscope Commercial |
$78.51
|
| Rate for Payer: Healthscope Whirlpool |
$76.15
|
| Rate for Payer: Mclaren Commercial |
$70.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.73
|
| Rate for Payer: Nomi Health Commercial |
$64.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.09
|
|
|
HC PROGESTERONE LEVEL
|
Facility
|
OP
|
$78.51
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
30100400
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.18 |
| Max. Negotiated Rate |
$78.51 |
| Rate for Payer: Aetna Commercial |
$70.66
|
| Rate for Payer: Aetna Medicare |
$20.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.07
|
| Rate for Payer: ASR ASR |
$76.15
|
| Rate for Payer: ASR Commercial |
$76.15
|
| Rate for Payer: BCBS Complete |
$11.74
|
| Rate for Payer: BCBS MAPPO |
$20.86
|
| Rate for Payer: BCBS Trust/PPO |
$64.29
|
| Rate for Payer: BCN Commercial |
$60.87
|
| Rate for Payer: BCN Medicare Advantage |
$20.86
|
| Rate for Payer: Cash Price |
$62.81
|
| Rate for Payer: Cash Price |
$62.81
|
| Rate for Payer: Cofinity Commercial |
$73.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$78.51
|
| Rate for Payer: Healthscope Whirlpool |
$76.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.86
|
| Rate for Payer: Mclaren Commercial |
$70.66
|
| Rate for Payer: Mclaren Medicaid |
$11.18
|
| Rate for Payer: Mclaren Medicare |
$20.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.90
|
| Rate for Payer: Meridian Medicaid |
$11.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.73
|
| Rate for Payer: Nomi Health Commercial |
$64.38
|
| Rate for Payer: PACE Medicare |
$19.82
|
| Rate for Payer: PACE SWMI |
$20.86
|
| Rate for Payer: PHP Commercial |
$22.95
|
| Rate for Payer: PHP Medicaid |
$11.18
|
| Rate for Payer: PHP Medicare Advantage |
$20.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.79
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: Priority Health Narrow Network |
$55.04
|
| Rate for Payer: Railroad Medicare Medicare |
$20.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.86
|
| Rate for Payer: UHC Exchange |
$32.33
|
| Rate for Payer: UHC Medicare Advantage |
$20.86
|
| Rate for Payer: UHCCP DNSP |
$20.86
|
| Rate for Payer: UHCCP Medicaid |
$11.18
|
| Rate for Payer: VA VA |
$20.86
|
|
|
HC PROLACTIN
|
Facility
|
IP
|
$73.87
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
30100402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$73.87 |
| Rate for Payer: Aetna Commercial |
$66.48
|
| Rate for Payer: ASR ASR |
$71.65
|
| Rate for Payer: ASR Commercial |
$71.65
|
| Rate for Payer: BCBS Trust/PPO |
$60.20
|
| Rate for Payer: BCN Commercial |
$57.27
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cofinity Commercial |
$69.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.10
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Healthscope Whirlpool |
$71.65
|
| Rate for Payer: Mclaren Commercial |
$66.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$60.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.01
|
|
|
HC PROLACTIN
|
Facility
|
OP
|
$73.87
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
30100402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.39 |
| Max. Negotiated Rate |
$73.87 |
| Rate for Payer: Aetna Commercial |
$66.48
|
| Rate for Payer: Aetna Medicare |
$19.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.23
|
| Rate for Payer: ASR ASR |
$71.65
|
| Rate for Payer: ASR Commercial |
$71.65
|
| Rate for Payer: BCBS Complete |
$10.91
|
| Rate for Payer: BCBS MAPPO |
$19.38
|
| Rate for Payer: BCBS Trust/PPO |
$60.49
|
| Rate for Payer: BCN Commercial |
$57.27
|
| Rate for Payer: BCN Medicare Advantage |
$19.38
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cofinity Commercial |
$69.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.38
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Healthscope Whirlpool |
$71.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.38
|
| Rate for Payer: Mclaren Commercial |
$66.48
|
| Rate for Payer: Mclaren Medicaid |
$10.39
|
| Rate for Payer: Mclaren Medicare |
$19.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.35
|
| Rate for Payer: Meridian Medicaid |
$10.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$60.57
|
| Rate for Payer: PACE Medicare |
$18.41
|
| Rate for Payer: PACE SWMI |
$19.38
|
| Rate for Payer: PHP Commercial |
$21.32
|
| Rate for Payer: PHP Medicaid |
$10.39
|
| Rate for Payer: PHP Medicare Advantage |
$19.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.72
|
| Rate for Payer: Priority Health Medicare |
$19.38
|
| Rate for Payer: Priority Health Narrow Network |
$51.78
|
| Rate for Payer: Railroad Medicare Medicare |
$19.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.38
|
| Rate for Payer: UHC Exchange |
$30.04
|
| Rate for Payer: UHC Medicare Advantage |
$19.38
|
| Rate for Payer: UHCCP DNSP |
$19.38
|
| Rate for Payer: UHCCP Medicaid |
$10.39
|
| Rate for Payer: VA VA |
$19.38
|
|
