|
HC REPLACE SQ ICD ONLY
|
Facility
|
OP
|
$36,955.60
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,591.56 |
| Max. Negotiated Rate |
$36,955.60 |
| Rate for Payer: Aetna Commercial |
$33,260.04
|
| Rate for Payer: Aetna Medicare |
$22,163.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,704.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,704.49
|
| Rate for Payer: ASR ASR |
$35,846.93
|
| Rate for Payer: BCBS Complete |
$12,172.24
|
| Rate for Payer: BCBS MAPPO |
$22,163.59
|
| Rate for Payer: BCBS Trust/PPO |
$30,469.89
|
| Rate for Payer: BCN Commercial |
$30,469.89
|
| Rate for Payer: BCN Medicare Advantage |
$22,163.59
|
| Rate for Payer: Cash Price |
$29,564.48
|
| Rate for Payer: Cash Price |
$29,564.48
|
| Rate for Payer: Cofinity Commercial |
$34,738.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29,564.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,163.59
|
| Rate for Payer: Healthscope Commercial |
$35,846.93
|
| Rate for Payer: Healthscope Whirlpool |
$36,955.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,163.59
|
| Rate for Payer: Mclaren Commercial |
$33,260.04
|
| Rate for Payer: Mclaren Medicaid |
$22,163.59
|
| Rate for Payer: Mclaren Medicare |
$22,163.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,271.77
|
| Rate for Payer: Meridian Medicaid |
$12,172.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,488.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,379.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,412.26
|
| Rate for Payer: Nomi Health Commercial |
$30,303.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27,716.70
|
| Rate for Payer: PACE Medicare |
$21,055.41
|
| Rate for Payer: PACE SWMI |
$22,163.59
|
| Rate for Payer: PHP Commercial |
$24,379.95
|
| Rate for Payer: PHP Medicaid |
$11,879.68
|
| Rate for Payer: PHP Medicare Advantage |
$22,163.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,591.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32,380.50
|
| Rate for Payer: Priority Health Medicare |
$22,163.59
|
| Rate for Payer: Priority Health Narrow Network |
$25,905.88
|
| Rate for Payer: Railroad Medicare Medicare |
$22,163.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32,520.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,163.59
|
| Rate for Payer: UHC Exchange |
$34,353.56
|
| Rate for Payer: UHC Medicaid |
$11,591.56
|
| Rate for Payer: UHCCP DNSP |
$22,163.59
|
| Rate for Payer: UHCCP Medicaid |
$11,591.56
|
| Rate for Payer: VA VA |
$22,163.59
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
IP
|
$36,955.60
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$27,716.70 |
| Max. Negotiated Rate |
$36,955.60 |
| Rate for Payer: Aetna Commercial |
$33,260.04
|
| Rate for Payer: ASR ASR |
$35,846.93
|
| Rate for Payer: BCBS Trust/PPO |
$30,347.94
|
| Rate for Payer: BCN Commercial |
$30,347.94
|
| Rate for Payer: Cash Price |
$29,564.48
|
| Rate for Payer: Cofinity Commercial |
$34,738.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29,564.48
|
| Rate for Payer: Healthscope Commercial |
$35,846.93
|
| Rate for Payer: Healthscope Whirlpool |
$36,955.60
|
| Rate for Payer: Mclaren Commercial |
$33,260.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,412.26
|
| Rate for Payer: Nomi Health Commercial |
$30,303.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27,716.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32,520.93
|
|
|
HC REPOSITION CVAC
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,919.25 |
| Max. Negotiated Rate |
$2,559.00 |
| Rate for Payer: Aetna Commercial |
$2,303.10
|
| Rate for Payer: ASR ASR |
$2,482.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.45
|
| Rate for Payer: BCN Commercial |
$2,101.45
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cofinity Commercial |
$2,405.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,047.20
|
| Rate for Payer: Healthscope Commercial |
$2,482.23
|
| Rate for Payer: Healthscope Whirlpool |
$2,559.00
|
| Rate for Payer: Mclaren Commercial |
$2,303.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,175.15
|
| Rate for Payer: Nomi Health Commercial |
$2,098.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,919.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,251.92
|
|
|
HC REPOSITION CVAC
|
Facility
|
OP
|
$2,559.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,559.00 |
| Rate for Payer: Aetna Commercial |
$2,303.10
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$2,482.23
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,109.90
|
| Rate for Payer: BCN Commercial |
$2,109.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cofinity Commercial |
$2,405.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,047.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$2,482.23
|
| Rate for Payer: Healthscope Whirlpool |
$2,559.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$2,303.10
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,175.15
|
| Rate for Payer: Nomi Health Commercial |
$2,098.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,919.25
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,242.20
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,793.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,251.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$3,000.46
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,700.41
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,910.45
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,473.88
|
| Rate for Payer: BCN Commercial |
$2,473.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cofinity Commercial |
$2,820.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,400.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,910.45
|
| Rate for Payer: Healthscope Whirlpool |
$3,000.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,700.41
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,550.39
|
| Rate for Payer: Nomi Health Commercial |
$2,460.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,629.00
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,103.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,640.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$3,000.46
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,250.34 |
| Max. Negotiated Rate |
$3,000.46 |
| Rate for Payer: Aetna Commercial |
$2,700.41
|
| Rate for Payer: ASR ASR |
$2,910.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,463.98
|
| Rate for Payer: BCN Commercial |
$2,463.98
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cofinity Commercial |
$2,820.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,400.37
|
| Rate for Payer: Healthscope Commercial |
$2,910.45
|
| Rate for Payer: Healthscope Whirlpool |
$3,000.46
|
| Rate for Payer: Mclaren Commercial |
$2,700.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,550.39
|
| Rate for Payer: Nomi Health Commercial |
$2,460.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,640.40
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$109.24
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.42 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna Medicare |
$40.42
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: BCBS Complete |
$43.70
|
| Rate for Payer: BCBS Trust/PPO |
$90.07
|
| Rate for Payer: BCN Commercial |
$90.07
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$105.96
|
| Rate for Payer: Healthscope Whirlpool |
$109.24
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.72
|
| Rate for Payer: Priority Health Narrow Network |
$76.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$109.24
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: BCBS Trust/PPO |
$89.71
|
| Rate for Payer: BCN Commercial |
$89.71
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$105.96
|
| Rate for Payer: Healthscope Whirlpool |
$109.24
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$11.55
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$25.73
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.35
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$11.55
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$25.73
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.35
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
IP
|
$858.33
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$643.75 |
| Max. Negotiated Rate |
$858.33 |
| Rate for Payer: Aetna Commercial |
$772.50
|
| Rate for Payer: ASR ASR |
$832.58
|
| Rate for Payer: BCBS Trust/PPO |
$704.86
|
| Rate for Payer: BCN Commercial |
$704.86
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Commercial |
$806.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$832.58
|
| Rate for Payer: Healthscope Whirlpool |
$858.33
|
| Rate for Payer: Mclaren Commercial |
$772.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Nomi Health Commercial |
$703.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.33
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
OP
|
$858.33
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$858.33 |
| Rate for Payer: Aetna Commercial |
$772.50
|
| Rate for Payer: Aetna Medicare |
$317.58
|
| Rate for Payer: ASR ASR |
$832.58
|
| Rate for Payer: BCBS Complete |
$343.33
|
| Rate for Payer: BCBS Trust/PPO |
$707.69
|
| Rate for Payer: BCN Commercial |
$707.69
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Commercial |
$806.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$832.58
|
| Rate for Payer: Healthscope Whirlpool |
$858.33
|
| Rate for Payer: Mclaren Commercial |
$772.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Nomi Health Commercial |
$703.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$752.07
|
| Rate for Payer: Priority Health Narrow Network |
$601.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.33
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
IP
|
$181.98
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$136.49 |
| Max. Negotiated Rate |
$181.98 |
| Rate for Payer: Aetna Commercial |
$163.78
|
| Rate for Payer: ASR ASR |
$176.52
|
| Rate for Payer: BCBS Trust/PPO |
$149.44
|
| Rate for Payer: BCN Commercial |
$149.44
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cofinity Commercial |
$171.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.58
|
| Rate for Payer: Healthscope Commercial |
$176.52
|
| Rate for Payer: Healthscope Whirlpool |
$181.98
|
| Rate for Payer: Mclaren Commercial |
$163.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.68
|
| Rate for Payer: Nomi Health Commercial |
$149.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.14
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
OP
|
$181.98
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$163.78
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$176.52
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$150.04
|
| Rate for Payer: BCN Commercial |
$150.04
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cofinity Commercial |
$171.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$176.52
|
| Rate for Payer: Healthscope Whirlpool |
$181.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$163.78
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.68
|
| Rate for Payer: Nomi Health Commercial |
$149.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.49
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.45
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$127.57
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$1,075.70
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$397.86 |
| Max. Negotiated Rate |
$1,075.70 |
| Rate for Payer: Aetna Commercial |
$968.13
|
| Rate for Payer: Aetna Medicare |
$398.01
|
| Rate for Payer: ASR ASR |
$1,043.43
|
| Rate for Payer: BCBS Complete |
$430.28
|
| Rate for Payer: BCBS Trust/PPO |
$886.91
|
| Rate for Payer: BCN Commercial |
$886.91
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cofinity Commercial |
$1,011.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.56
|
| Rate for Payer: Healthscope Commercial |
$1,043.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,075.70
|
| Rate for Payer: Mclaren Commercial |
$968.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.35
|
| Rate for Payer: Nomi Health Commercial |
$882.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$497.32
|
| Rate for Payer: Priority Health Narrow Network |
$397.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$946.62
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,075.70
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$806.77 |
| Max. Negotiated Rate |
$1,075.70 |
| Rate for Payer: Aetna Commercial |
$968.13
|
| Rate for Payer: ASR ASR |
$1,043.43
|
| Rate for Payer: BCBS Trust/PPO |
$883.36
|
| Rate for Payer: BCN Commercial |
$883.36
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cofinity Commercial |
$1,011.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.56
|
| Rate for Payer: Healthscope Commercial |
$1,043.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,075.70
|
| Rate for Payer: Mclaren Commercial |
$968.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.35
|
| Rate for Payer: Nomi Health Commercial |
$882.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$946.62
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$103.62
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Aetna Commercial |
$93.26
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: ASR ASR |
$100.51
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$85.43
|
| Rate for Payer: BCN Commercial |
$85.43
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cofinity Commercial |
$97.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$100.51
|
| Rate for Payer: Healthscope Whirlpool |
$103.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.10
|
| Rate for Payer: Mclaren Commercial |
$93.26
|
| Rate for Payer: Mclaren Medicaid |
$13.10
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$7.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.08
|
| Rate for Payer: Nomi Health Commercial |
$84.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.72
|
| Rate for Payer: PACE Medicare |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$14.41
|
| Rate for Payer: PHP Medicaid |
$7.02
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90.79
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$72.64
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.10
|
| Rate for Payer: UHC Exchange |
$20.30
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP DNSP |
$13.10
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$13.10
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$103.62
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Aetna Commercial |
$93.26
|
| Rate for Payer: ASR ASR |
$100.51
|
| Rate for Payer: BCBS Trust/PPO |
$85.09
|
| Rate for Payer: BCN Commercial |
$85.09
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cofinity Commercial |
$97.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.90
|
| Rate for Payer: Healthscope Commercial |
$100.51
|
| Rate for Payer: Healthscope Whirlpool |
$103.62
|
| Rate for Payer: Mclaren Commercial |
$93.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.08
|
| Rate for Payer: Nomi Health Commercial |
$84.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.19
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$74.70
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$67.23
|
| Rate for Payer: ASR ASR |
$72.46
|
| Rate for Payer: BCBS Trust/PPO |
$61.34
|
| Rate for Payer: BCN Commercial |
$61.34
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$70.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$72.46
|
| Rate for Payer: Healthscope Whirlpool |
$74.70
|
| Rate for Payer: Mclaren Commercial |
$67.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Nomi Health Commercial |
$61.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.74
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$74.70
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$67.23
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.77
|
| Rate for Payer: ASR ASR |
$72.46
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$61.59
|
| Rate for Payer: BCN Commercial |
$61.59
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$70.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$72.46
|
| Rate for Payer: Healthscope Whirlpool |
$74.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.42
|
| Rate for Payer: Mclaren Commercial |
$67.23
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Nomi Health Commercial |
$61.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.02
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Medicaid |
$7.19
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.45
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$52.36
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.42
|
| Rate for Payer: UHC Exchange |
$20.80
|
| Rate for Payer: UHC Medicaid |
$7.02
|
| Rate for Payer: UHCCP DNSP |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: VA VA |
$13.42
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$59.19
|
| Rate for Payer: BCN Commercial |
$59.19
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$69.64
|
| Rate for Payer: Healthscope Whirlpool |
$71.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.90
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$50.32
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: VA VA |
$11.98
|
|
