|
HC RUBELLA ANTIBODY IGC
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$143.46 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$14.39
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$7.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.39
|
| Rate for Payer: UHC Exchange |
$22.30
|
| Rate for Payer: UHC Medicaid |
$7.53
|
| Rate for Payer: UHCCP DNSP |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.53
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$143.46 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$14.39
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$7.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.39
|
| Rate for Payer: UHC Exchange |
$22.30
|
| Rate for Payer: UHC Medicaid |
$7.53
|
| Rate for Payer: UHCCP DNSP |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.53
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
OP
|
$89.58
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.74 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: Aetna Medicare |
$12.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: ASR ASR |
$86.89
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$73.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$86.89
|
| Rate for Payer: Healthscope Whirlpool |
$89.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.88
|
| Rate for Payer: Mclaren Commercial |
$80.62
|
| Rate for Payer: Mclaren Medicaid |
$12.88
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$14.17
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.88
|
| Rate for Payer: UHC Exchange |
$19.96
|
| Rate for Payer: UHC Medicaid |
$6.74
|
| Rate for Payer: UHCCP DNSP |
$12.88
|
| Rate for Payer: UHCCP Medicaid |
$6.74
|
| Rate for Payer: VA VA |
$12.88
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
IP
|
$89.58
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$67.19 |
| Max. Negotiated Rate |
$89.58 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: ASR ASR |
$86.89
|
| Rate for Payer: BCBS Trust/PPO |
$73.56
|
| Rate for Payer: BCN Commercial |
$73.56
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$86.89
|
| Rate for Payer: Healthscope Whirlpool |
$89.58
|
| Rate for Payer: Mclaren Commercial |
$80.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.83
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
IP
|
$2,091.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,568.25 |
| Max. Negotiated Rate |
$2,091.00 |
| Rate for Payer: Aetna Commercial |
$1,881.90
|
| Rate for Payer: ASR ASR |
$2,028.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,717.13
|
| Rate for Payer: BCN Commercial |
$1,717.13
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cofinity Commercial |
$1,965.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.80
|
| Rate for Payer: Healthscope Commercial |
$2,028.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,091.00
|
| Rate for Payer: Mclaren Commercial |
$1,881.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.35
|
| Rate for Payer: Nomi Health Commercial |
$1,714.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,840.08
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
OP
|
$2,091.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$416.90 |
| Max. Negotiated Rate |
$2,091.00 |
| Rate for Payer: Aetna Commercial |
$1,881.90
|
| Rate for Payer: Aetna Medicare |
$773.67
|
| Rate for Payer: ASR ASR |
$2,028.27
|
| Rate for Payer: BCBS Complete |
$836.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.03
|
| Rate for Payer: BCN Commercial |
$1,724.03
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cofinity Commercial |
$1,965.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.80
|
| Rate for Payer: Healthscope Commercial |
$2,028.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,091.00
|
| Rate for Payer: Mclaren Commercial |
$1,881.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,672.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.35
|
| Rate for Payer: Nomi Health Commercial |
$1,714.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$521.12
|
| Rate for Payer: Priority Health Narrow Network |
$416.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,840.08
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
OP
|
$62.84
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.01 |
| Max. Negotiated Rate |
$163.42 |
| Rate for Payer: Aetna Commercial |
$56.56
|
| Rate for Payer: Aetna Medicare |
$9.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.97
|
| Rate for Payer: ASR ASR |
$60.95
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: BCBS MAPPO |
$9.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.81
|
| Rate for Payer: BCN Commercial |
$51.81
|
| Rate for Payer: BCN Medicare Advantage |
$9.58
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Commercial |
$59.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.58
|
| Rate for Payer: Healthscope Commercial |
$60.95
|
| Rate for Payer: Healthscope Whirlpool |
$62.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.58
|
| Rate for Payer: Mclaren Commercial |
$56.56
|
| Rate for Payer: Mclaren Medicaid |
$9.58
|
| Rate for Payer: Mclaren Medicare |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.06
|
| Rate for Payer: Meridian Medicaid |
$5.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PACE Medicare |
$9.10
|
| Rate for Payer: PACE SWMI |
$9.58
|
| Rate for Payer: PHP Commercial |
$10.54
|
| Rate for Payer: PHP Medicaid |
$5.13
|
| Rate for Payer: PHP Medicare Advantage |
$9.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$163.42
|
| Rate for Payer: Priority Health Medicare |
$9.58
|
| Rate for Payer: Priority Health Narrow Network |
$130.74
|
| Rate for Payer: Railroad Medicare Medicare |
$9.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.58
|
| Rate for Payer: UHC Exchange |
$14.85
|
| Rate for Payer: UHC Medicaid |
$5.01
|
| Rate for Payer: UHCCP DNSP |
$9.58
|
| Rate for Payer: UHCCP Medicaid |
$5.01
|
| Rate for Payer: VA VA |
$9.58
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
IP
|
$62.84
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.13 |
| Max. Negotiated Rate |
$62.84 |
| Rate for Payer: Aetna Commercial |
$56.56
|
| Rate for Payer: ASR ASR |
$60.95
|
| Rate for Payer: BCBS Trust/PPO |
$51.60
|
| Rate for Payer: BCN Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Commercial |
$59.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$60.95
|
| Rate for Payer: Healthscope Whirlpool |
$62.84
|
| Rate for Payer: Mclaren Commercial |
$56.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.30
|
|
|
HC RUSSIAN THISTLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
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 RUSSIAN THISTLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
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 SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
IP
|
$1,379.57
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,034.68 |
| Max. Negotiated Rate |
$1,379.57 |
| Rate for Payer: Aetna Commercial |
$1,241.61
|
| Rate for Payer: ASR ASR |
$1,338.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.90
|
| Rate for Payer: BCN Commercial |
$1,132.90
|
| Rate for Payer: Cash Price |
$1,103.66
|
| Rate for Payer: Cofinity Commercial |
$1,296.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.66
|
| Rate for Payer: Healthscope Commercial |
$1,338.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,379.57
|
| Rate for Payer: Mclaren Commercial |
$1,241.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,172.63
|
| Rate for Payer: Nomi Health Commercial |
$1,131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,034.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.02
|
|
|
HC SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
OP
|
$1,379.57
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$510.44 |
| Max. Negotiated Rate |
$1,379.57 |
| Rate for Payer: Aetna Commercial |
$1,241.61
|
| Rate for Payer: Aetna Medicare |
$510.44
|
| Rate for Payer: ASR ASR |
$1,338.18
|
| Rate for Payer: BCBS Complete |
$551.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.46
|
| Rate for Payer: BCN Commercial |
$1,137.46
|
| Rate for Payer: Cash Price |
$1,103.66
|
| Rate for Payer: Cofinity Commercial |
$1,296.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.66
|
| Rate for Payer: Healthscope Commercial |
$1,338.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,379.57
|
| Rate for Payer: Mclaren Commercial |
$1,241.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,103.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,172.63
|
| Rate for Payer: Nomi Health Commercial |
$1,131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,034.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,208.78
|
| Rate for Payer: Priority Health Narrow Network |
$967.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.02
|
|
|
HC SAFE SHEATH LEAD INTRODUCER
|
Facility
|
OP
|
$2,000.00
|
|
| Hospital Charge Code |
27200400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$740.00 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Aetna Commercial |
$1,800.00
|
| Rate for Payer: Aetna Medicare |
$740.00
|
| Rate for Payer: ASR ASR |
$1,940.00
|
| Rate for Payer: BCBS Complete |
$800.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,649.00
|
| Rate for Payer: BCN Commercial |
$1,649.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$1,880.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.00
|
| Rate for Payer: Healthscope Commercial |
$1,940.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,000.00
|
| Rate for Payer: Mclaren Commercial |
$1,800.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,600.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.00
|
| Rate for Payer: Nomi Health Commercial |
$1,640.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,752.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.00
|
|
|
HC SAFE SHEATH LEAD INTRODUCER
|
Facility
|
IP
|
$2,000.00
|
|
| Hospital Charge Code |
27200400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,500.00 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Aetna Commercial |
$1,800.00
|
| Rate for Payer: ASR ASR |
$1,940.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,642.40
|
| Rate for Payer: BCN Commercial |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$1,880.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.00
|
| Rate for Payer: Healthscope Commercial |
$1,940.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,000.00
|
| Rate for Payer: Mclaren Commercial |
$1,800.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.00
|
| Rate for Payer: Nomi Health Commercial |
$1,640.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.00
|
|
|
HC SALICYLATE LVL.
|
Facility
|
OP
|
$104.49
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100649
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$94.04
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$101.36
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$86.15
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$98.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$101.36
|
| Rate for Payer: Healthscope Whirlpool |
$104.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$94.04
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$85.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$91.55
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$73.25
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC SALICYLATE LVL.
|
Facility
|
IP
|
$104.49
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100649
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.37 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$94.04
|
| Rate for Payer: ASR ASR |
$101.36
|
| Rate for Payer: BCBS Trust/PPO |
$85.81
|
| Rate for Payer: BCN Commercial |
$85.81
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$98.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Healthscope Commercial |
$101.36
|
| Rate for Payer: Healthscope Whirlpool |
$104.49
|
| Rate for Payer: Mclaren Commercial |
$94.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$85.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.95
|
|
|
HC SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| 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 |
$41.18
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| 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 |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| 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 |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.19
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$29.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC SALMON IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
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 SALMON IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
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 SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
IP
|
$12,927.24
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$9,695.43 |
| Max. Negotiated Rate |
$12,927.24 |
| Rate for Payer: Aetna Commercial |
$11,634.52
|
| Rate for Payer: ASR ASR |
$12,539.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.85
|
| Rate for Payer: BCN Commercial |
$10,615.85
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cofinity Commercial |
$12,151.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,341.79
|
| Rate for Payer: Healthscope Commercial |
$12,539.42
|
| Rate for Payer: Healthscope Whirlpool |
$12,927.24
|
| Rate for Payer: Mclaren Commercial |
$11,634.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,988.15
|
| Rate for Payer: Nomi Health Commercial |
$10,600.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,695.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,375.97
|
|
|
HC SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
OP
|
$12,927.24
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,652.58 |
| Max. Negotiated Rate |
$16,608.54 |
| Rate for Payer: Aetna Commercial |
$11,634.52
|
| Rate for Payer: Aetna Medicare |
$3,159.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,949.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,949.75
|
| Rate for Payer: ASR ASR |
$12,539.42
|
| Rate for Payer: BCBS Complete |
$1,735.36
|
| Rate for Payer: BCBS MAPPO |
$3,159.80
|
| Rate for Payer: BCBS Trust/PPO |
$10,658.51
|
| Rate for Payer: BCN Commercial |
$10,658.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,159.80
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cofinity Commercial |
$12,151.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,341.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,159.80
|
| Rate for Payer: Healthscope Commercial |
$12,539.42
|
| Rate for Payer: Healthscope Whirlpool |
$12,927.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,159.80
|
| Rate for Payer: Mclaren Commercial |
$11,634.52
|
| Rate for Payer: Mclaren Medicaid |
$3,159.80
|
| Rate for Payer: Mclaren Medicare |
$3,159.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,317.79
|
| Rate for Payer: Meridian Medicaid |
$1,735.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,633.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,475.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,988.15
|
| Rate for Payer: Nomi Health Commercial |
$10,600.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,695.43
|
| Rate for Payer: PACE Medicare |
$3,001.81
|
| Rate for Payer: PACE SWMI |
$3,159.80
|
| Rate for Payer: PHP Commercial |
$3,475.78
|
| Rate for Payer: PHP Medicaid |
$1,693.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,159.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16,608.54
|
| Rate for Payer: Priority Health Medicare |
$3,159.80
|
| Rate for Payer: Priority Health Narrow Network |
$13,286.83
|
| Rate for Payer: Railroad Medicare Medicare |
$3,159.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,375.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,159.80
|
| Rate for Payer: UHC Exchange |
$4,897.69
|
| Rate for Payer: UHC Medicaid |
$1,652.58
|
| Rate for Payer: UHCCP DNSP |
$3,159.80
|
| Rate for Payer: UHCCP Medicaid |
$1,652.58
|
| Rate for Payer: VA VA |
$3,159.80
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.13 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Trust/PPO |
$59.27
|
| Rate for Payer: BCN Commercial |
$59.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.03 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Complete |
$23.14
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCBS Trust/PPO |
$59.50
|
| Rate for Payer: BCN Commercial |
$59.50
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.13
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Mclaren Medicaid |
$42.13
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$23.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$46.34
|
| Rate for Payer: PHP Medicaid |
$22.58
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53.18
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health Narrow Network |
$42.55
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.13
|
| Rate for Payer: UHC Exchange |
$65.30
|
| Rate for Payer: UHC Medicaid |
$22.03
|
| Rate for Payer: UHCCP DNSP |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$22.03
|
| Rate for Payer: VA VA |
$42.13
|
|
