|
HC PROLONGED E/M BEFORE/AFTER DIRECT CARE 1ST HR
|
Facility
|
OP
|
$131.61
|
|
|
Service Code
|
CPT 99358
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.64 |
| Max. Negotiated Rate |
$131.61 |
| Rate for Payer: Aetna Commercial |
$118.45
|
| Rate for Payer: Aetna Medicare |
$65.81
|
| Rate for Payer: ASR ASR |
$127.66
|
| Rate for Payer: ASR Commercial |
$127.66
|
| Rate for Payer: BCBS Complete |
$52.64
|
| Rate for Payer: BCBS Trust/PPO |
$107.78
|
| Rate for Payer: BCN Commercial |
$102.04
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cofinity Commercial |
$123.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.29
|
| Rate for Payer: Healthscope Commercial |
$131.61
|
| Rate for Payer: Healthscope Whirlpool |
$127.66
|
| Rate for Payer: Mclaren Commercial |
$118.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.87
|
| Rate for Payer: Nomi Health Commercial |
$107.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.32
|
| Rate for Payer: Priority Health Narrow Network |
$92.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.82
|
|
|
HC PROLONGED E/M BEFORE/AFTER DIRECT CARE 1ST HR
|
Facility
|
IP
|
$131.61
|
|
|
Service Code
|
CPT 99358
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$85.55 |
| Max. Negotiated Rate |
$131.61 |
| Rate for Payer: Aetna Commercial |
$118.45
|
| Rate for Payer: ASR ASR |
$127.66
|
| Rate for Payer: ASR Commercial |
$127.66
|
| Rate for Payer: BCBS Trust/PPO |
$107.25
|
| Rate for Payer: BCN Commercial |
$102.04
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cofinity Commercial |
$123.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.29
|
| Rate for Payer: Healthscope Commercial |
$131.61
|
| Rate for Payer: Healthscope Whirlpool |
$127.66
|
| Rate for Payer: Mclaren Commercial |
$118.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.87
|
| Rate for Payer: Nomi Health Commercial |
$107.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.82
|
|
|
HC PROLONGED OUTPATIENT OFFICE VISIT
|
Facility
|
OP
|
$29.92
|
|
|
Service Code
|
HCPCS G2212
|
| Hospital Charge Code |
51000098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$29.92 |
| Rate for Payer: Aetna Commercial |
$26.93
|
| Rate for Payer: Aetna Medicare |
$14.96
|
| Rate for Payer: ASR ASR |
$29.02
|
| Rate for Payer: ASR Commercial |
$29.02
|
| Rate for Payer: BCBS Complete |
$11.97
|
| Rate for Payer: BCBS Trust/PPO |
$24.50
|
| Rate for Payer: BCN Commercial |
$23.20
|
| Rate for Payer: Cash Price |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$28.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.94
|
| Rate for Payer: Healthscope Commercial |
$29.92
|
| Rate for Payer: Healthscope Whirlpool |
$29.02
|
| Rate for Payer: Mclaren Commercial |
$26.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.43
|
| Rate for Payer: Nomi Health Commercial |
$24.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.22
|
| Rate for Payer: Priority Health Narrow Network |
$20.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.33
|
|
|
HC PROLONGED OUTPATIENT OFFICE VISIT
|
Facility
|
IP
|
$29.92
|
|
|
Service Code
|
HCPCS G2212
|
| Hospital Charge Code |
51000098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$29.92 |
| Rate for Payer: Aetna Commercial |
$26.93
|
| Rate for Payer: ASR ASR |
$29.02
|
| Rate for Payer: ASR Commercial |
$29.02
|
| Rate for Payer: BCBS Trust/PPO |
$24.38
|
| Rate for Payer: BCN Commercial |
$23.20
|
| Rate for Payer: Cash Price |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$28.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.94
|
| Rate for Payer: Healthscope Commercial |
$29.92
|
| Rate for Payer: Healthscope Whirlpool |
$29.02
|
| Rate for Payer: Mclaren Commercial |
$26.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.43
|
| Rate for Payer: Nomi Health Commercial |
$24.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.33
|
|
|
HC PROPOXYPHENE URINE
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100055
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.96 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
|
|
HC PROPOXYPHENE URINE
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100055
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$26.41
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.50
|
| Rate for Payer: PHP Medicaid |
$9.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.26
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$22.61
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC PROPOXYPHENE URINE CMPT
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$26.41
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.50
|
| Rate for Payer: PHP Medicaid |
$9.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.26
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$22.61
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC PROPOXYPHENE URINE CMPT
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.96 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: ASR ASR |
$31.28
|
| Rate for Payer: ASR Commercial |
$31.28
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$32.25
|
| Rate for Payer: Healthscope Whirlpool |
$31.28
|
| Rate for Payer: Mclaren Commercial |
$29.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.38
|
|
|
HC PRO PREDICT 6 MP COMPONENT.
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100629
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$298.86 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: ASR Commercial |
$289.89
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$244.74
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.03
|
| Rate for Payer: Nomi Health Commercial |
$245.07
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$26.50
|
| Rate for Payer: PHP Medicaid |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.86
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$209.50
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP DNSP |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC PRO PREDICT 6 MP COMPONENT.
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100629
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$298.86 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: ASR Commercial |
$289.89
|
| Rate for Payer: BCBS Trust/PPO |
$243.54
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.03
|
| Rate for Payer: Nomi Health Commercial |
$245.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
|
|
HC PROSTHETIC TRNG INITIAL EACH 15 MIN
|
Facility
|
OP
|
$120.03
|
|
|
Service Code
|
CPT 97761
|
| Hospital Charge Code |
42000040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$48.01 |
| Max. Negotiated Rate |
$120.03 |
| Rate for Payer: Aetna Commercial |
$108.03
|
| Rate for Payer: Aetna Medicare |
$60.02
|
| Rate for Payer: ASR ASR |
$116.43
|
| Rate for Payer: ASR Commercial |
$116.43
|
| Rate for Payer: BCBS Complete |
$48.01
|
| Rate for Payer: BCBS Trust/PPO |
$98.29
|
| Rate for Payer: BCN Commercial |
$93.06
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$112.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$120.03
|
| Rate for Payer: Healthscope Whirlpool |
$116.43
|
| Rate for Payer: Mclaren Commercial |
$108.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.03
|
| Rate for Payer: Nomi Health Commercial |
$98.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.17
|
| Rate for Payer: Priority Health Narrow Network |
$84.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.63
|
|
|
HC PROSTHETIC TRNG INITIAL EACH 15 MIN
|
Facility
|
IP
|
$120.03
|
|
|
Service Code
|
CPT 97761
|
| Hospital Charge Code |
42000040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$78.02 |
| Max. Negotiated Rate |
$120.03 |
| Rate for Payer: Aetna Commercial |
$108.03
|
| Rate for Payer: ASR ASR |
$116.43
|
| Rate for Payer: ASR Commercial |
$116.43
|
| Rate for Payer: BCBS Trust/PPO |
$97.81
|
| Rate for Payer: BCN Commercial |
$93.06
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$112.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$120.03
|
| Rate for Payer: Healthscope Whirlpool |
$116.43
|
| Rate for Payer: Mclaren Commercial |
$108.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.03
|
| Rate for Payer: Nomi Health Commercial |
$98.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.63
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
IP
|
$30.17
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$30.17 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: ASR ASR |
$29.26
|
| Rate for Payer: ASR Commercial |
$29.26
|
| Rate for Payer: BCBS Trust/PPO |
$24.59
|
| Rate for Payer: BCN Commercial |
$23.39
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$28.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$30.17
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Mclaren Commercial |
$27.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.55
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
OP
|
$30.17
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$30.17 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$29.26
|
| Rate for Payer: ASR Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$24.71
|
| Rate for Payer: BCN Commercial |
$23.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$28.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$30.17
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$27.15
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.43
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$21.15
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$63.46 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Medicare |
$13.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.30
|
| Rate for Payer: ASR ASR |
$61.56
|
| Rate for Payer: ASR Commercial |
$61.56
|
| Rate for Payer: BCBS Complete |
$7.79
|
| Rate for Payer: BCBS MAPPO |
$13.84
|
| Rate for Payer: BCBS Trust/PPO |
$51.97
|
| Rate for Payer: BCN Commercial |
$49.20
|
| Rate for Payer: BCN Medicare Advantage |
$13.84
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.84
|
| Rate for Payer: Healthscope Commercial |
$63.46
|
| Rate for Payer: Healthscope Whirlpool |
$61.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.84
|
| Rate for Payer: Mclaren Commercial |
$57.11
|
| Rate for Payer: Mclaren Medicaid |
$7.42
|
| Rate for Payer: Mclaren Medicare |
$13.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.53
|
| Rate for Payer: Meridian Medicaid |
$7.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: PACE Medicare |
$13.15
|
| Rate for Payer: PACE SWMI |
$13.84
|
| Rate for Payer: PHP Commercial |
$15.22
|
| Rate for Payer: PHP Medicaid |
$7.42
|
| Rate for Payer: PHP Medicare Advantage |
$13.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.60
|
| Rate for Payer: Priority Health Medicare |
$13.84
|
| Rate for Payer: Priority Health Narrow Network |
$44.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.84
|
| Rate for Payer: UHC Exchange |
$21.45
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
| Rate for Payer: UHCCP DNSP |
$13.84
|
| Rate for Payer: UHCCP Medicaid |
$7.42
|
| Rate for Payer: VA VA |
$13.84
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$63.46 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: ASR ASR |
$61.56
|
| Rate for Payer: ASR Commercial |
$61.56
|
| Rate for Payer: BCBS Trust/PPO |
$51.71
|
| Rate for Payer: BCN Commercial |
$49.20
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$63.46
|
| Rate for Payer: Healthscope Whirlpool |
$61.56
|
| Rate for Payer: Mclaren Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.84
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: Aetna Medicare |
$12.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.01
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Complete |
$6.76
|
| Rate for Payer: BCBS MAPPO |
$12.01
|
| Rate for Payer: BCBS Trust/PPO |
$45.94
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: BCN Medicare Advantage |
$12.01
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.01
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.01
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$6.44
|
| Rate for Payer: Mclaren Medicare |
$12.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.61
|
| Rate for Payer: Meridian Medicaid |
$6.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PACE Medicare |
$11.41
|
| Rate for Payer: PACE SWMI |
$12.01
|
| Rate for Payer: PHP Commercial |
$13.21
|
| Rate for Payer: PHP Medicaid |
$6.44
|
| Rate for Payer: PHP Medicare Advantage |
$12.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.15
|
| Rate for Payer: Priority Health Medicare |
$12.01
|
| Rate for Payer: Priority Health Narrow Network |
$39.33
|
| Rate for Payer: Railroad Medicare Medicare |
$12.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.01
|
| Rate for Payer: UHC Exchange |
$18.62
|
| Rate for Payer: UHC Medicare Advantage |
$12.01
|
| Rate for Payer: UHCCP DNSP |
$12.01
|
| Rate for Payer: UHCCP Medicaid |
$6.44
|
| Rate for Payer: VA VA |
$12.01
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$36.47 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Trust/PPO |
$45.72
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.43
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.74
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$5.76
|
| Rate for Payer: Mclaren Medicare |
$10.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$10.20
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$11.81
|
| Rate for Payer: PHP Medicaid |
$5.76
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.74
|
| Rate for Payer: UHC Exchange |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$10.74
|
| Rate for Payer: UHCCP DNSP |
$10.74
|
| Rate for Payer: UHCCP Medicaid |
$5.76
|
| Rate for Payer: VA VA |
$10.74
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
IP
|
$105.67
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$105.67 |
| Rate for Payer: Aetna Commercial |
$95.10
|
| Rate for Payer: ASR ASR |
$102.50
|
| Rate for Payer: ASR Commercial |
$102.50
|
| Rate for Payer: BCBS Trust/PPO |
$86.11
|
| Rate for Payer: BCN Commercial |
$81.93
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.54
|
| Rate for Payer: Healthscope Commercial |
$105.67
|
| Rate for Payer: Healthscope Whirlpool |
$102.50
|
| Rate for Payer: Mclaren Commercial |
$95.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.82
|
| Rate for Payer: Nomi Health Commercial |
$86.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.99
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
OP
|
$105.67
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$105.67 |
| Rate for Payer: Aetna Commercial |
$95.10
|
| Rate for Payer: Aetna Medicare |
$17.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.29
|
| Rate for Payer: ASR ASR |
$102.50
|
| Rate for Payer: ASR Commercial |
$102.50
|
| Rate for Payer: BCBS Complete |
$10.03
|
| Rate for Payer: BCBS MAPPO |
$17.83
|
| Rate for Payer: BCBS Trust/PPO |
$86.53
|
| Rate for Payer: BCN Commercial |
$81.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.83
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.83
|
| Rate for Payer: Healthscope Commercial |
$105.67
|
| Rate for Payer: Healthscope Whirlpool |
$102.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.83
|
| Rate for Payer: Mclaren Commercial |
$95.10
|
| Rate for Payer: Mclaren Medicaid |
$9.56
|
| Rate for Payer: Mclaren Medicare |
$17.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.72
|
| Rate for Payer: Meridian Medicaid |
$10.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.82
|
| Rate for Payer: Nomi Health Commercial |
$86.65
|
| Rate for Payer: PACE Medicare |
$16.94
|
| Rate for Payer: PACE SWMI |
$17.83
|
| Rate for Payer: PHP Commercial |
$19.61
|
| Rate for Payer: PHP Medicaid |
$9.56
|
| Rate for Payer: PHP Medicare Advantage |
$17.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.59
|
| Rate for Payer: Priority Health Medicare |
$17.83
|
| Rate for Payer: Priority Health Narrow Network |
$74.07
|
| Rate for Payer: Railroad Medicare Medicare |
$17.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.83
|
| Rate for Payer: UHC Exchange |
$27.64
|
| Rate for Payer: UHC Medicare Advantage |
$17.83
|
| Rate for Payer: UHCCP DNSP |
$17.83
|
| Rate for Payer: UHCCP Medicaid |
$9.56
|
| Rate for Payer: VA VA |
$17.83
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$15.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Complete |
$8.62
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.32
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$8.21
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$8.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$16.85
|
| Rate for Payer: PHP Medicaid |
$8.21
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.52
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health Narrow Network |
$43.62
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.32
|
| Rate for Payer: UHC Exchange |
$23.75
|
| Rate for Payer: UHC Medicare Advantage |
$15.32
|
| Rate for Payer: UHCCP DNSP |
$15.32
|
| Rate for Payer: UHCCP Medicaid |
$8.21
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.70
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$86.70 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: ASR ASR |
$84.10
|
| Rate for Payer: ASR Commercial |
$84.10
|
| Rate for Payer: BCBS Trust/PPO |
$70.65
|
| Rate for Payer: BCN Commercial |
$67.22
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$81.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$86.70
|
| Rate for Payer: Healthscope Whirlpool |
$84.10
|
| Rate for Payer: Mclaren Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.30
|
|
