|
HC STREP PNEUMONIAE ANTIGEN
|
Facility
|
IP
|
$80.53
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600147
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.34 |
| Max. Negotiated Rate |
$80.53 |
| Rate for Payer: Aetna Commercial |
$72.48
|
| Rate for Payer: ASR ASR |
$78.11
|
| Rate for Payer: ASR Commercial |
$78.11
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$62.43
|
| Rate for Payer: Cash Price |
$64.42
|
| Rate for Payer: Cofinity Commercial |
$75.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.42
|
| Rate for Payer: Healthscope Commercial |
$80.53
|
| Rate for Payer: Healthscope Whirlpool |
$78.11
|
| Rate for Payer: Mclaren Commercial |
$72.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.45
|
| Rate for Payer: Nomi Health Commercial |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.87
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$14.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.99
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$16.49
|
| Rate for Payer: PHP Medicaid |
$8.03
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.99
|
| Rate for Payer: UHC Exchange |
$23.23
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UHCCP DNSP |
$14.99
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: VA VA |
$14.99
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$14.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.99
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$16.49
|
| Rate for Payer: PHP Medicaid |
$8.03
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.99
|
| Rate for Payer: UHC Exchange |
$23.23
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UHCCP DNSP |
$14.99
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: VA VA |
$14.99
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| 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 STREPTOCOCCUS AGALACTIAE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| 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 |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| 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 |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| 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 STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
IP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$231.23 |
| Max. Negotiated Rate |
$355.74 |
| Rate for Payer: Aetna Commercial |
$320.17
|
| Rate for Payer: ASR ASR |
$345.07
|
| Rate for Payer: ASR Commercial |
$345.07
|
| Rate for Payer: BCBS Trust/PPO |
$289.89
|
| Rate for Payer: BCN Commercial |
$275.81
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$334.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Healthscope Commercial |
$355.74
|
| Rate for Payer: Healthscope Whirlpool |
$345.07
|
| Rate for Payer: Mclaren Commercial |
$320.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: Nomi Health Commercial |
$291.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.05
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
OP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$355.74 |
| Rate for Payer: Aetna Commercial |
$320.17
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$345.07
|
| Rate for Payer: ASR Commercial |
$345.07
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$291.32
|
| Rate for Payer: BCN Commercial |
$275.81
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$334.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$355.74
|
| Rate for Payer: Healthscope Whirlpool |
$345.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$320.17
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: Nomi Health Commercial |
$291.71
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.70
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$249.37
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC STRESS ECHO
|
Facility
|
OP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,515.37 |
| Rate for Payer: Aetna Commercial |
$1,363.83
|
| Rate for Payer: Aetna Medicare |
$534.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: ASR ASR |
$1,469.91
|
| Rate for Payer: ASR Commercial |
$1,469.91
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,240.94
|
| Rate for Payer: BCN Commercial |
$1,174.87
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,424.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,515.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,469.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$534.75
|
| Rate for Payer: Mclaren Commercial |
$1,363.83
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: Nomi Health Commercial |
$1,242.60
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$588.23
|
| Rate for Payer: PHP Medicaid |
$286.63
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.77
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,062.27
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,333.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$828.86
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP DNSP |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: VA VA |
$534.75
|
|
|
HC STRESS ECHO
|
Facility
|
IP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$984.99 |
| Max. Negotiated Rate |
$1,515.37 |
| Rate for Payer: Aetna Commercial |
$1,363.83
|
| Rate for Payer: ASR ASR |
$1,469.91
|
| Rate for Payer: ASR Commercial |
$1,469.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.88
|
| Rate for Payer: BCN Commercial |
$1,174.87
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,424.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Healthscope Commercial |
$1,515.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,469.91
|
| Rate for Payer: Mclaren Commercial |
$1,363.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: Nomi Health Commercial |
$1,242.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,333.53
|
|
|
HC STRESS TEST
|
Facility
|
IP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$586.26 |
| Max. Negotiated Rate |
$901.94 |
| Rate for Payer: Aetna Commercial |
$811.75
|
| Rate for Payer: ASR ASR |
$874.88
|
| Rate for Payer: ASR Commercial |
$874.88
|
| Rate for Payer: BCBS Trust/PPO |
$734.99
|
| Rate for Payer: BCN Commercial |
$699.27
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$847.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Healthscope Commercial |
$901.94
|
| Rate for Payer: Healthscope Whirlpool |
$874.88
|
| Rate for Payer: Mclaren Commercial |
$811.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: Nomi Health Commercial |
$739.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.71
|
|
|
HC STRESS TEST
|
Facility
|
OP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$901.94 |
| Rate for Payer: Aetna Commercial |
$811.75
|
| Rate for Payer: Aetna Medicare |
$303.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: ASR ASR |
$874.88
|
| Rate for Payer: ASR Commercial |
$874.88
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCBS Trust/PPO |
$738.60
|
| Rate for Payer: BCN Commercial |
$699.27
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$847.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$901.94
|
| Rate for Payer: Healthscope Whirlpool |
$874.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.70
|
| Rate for Payer: Mclaren Commercial |
$811.75
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: Nomi Health Commercial |
$739.59
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$334.07
|
| Rate for Payer: PHP Medicaid |
$162.78
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$790.28
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health Narrow Network |
$632.26
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$470.74
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP DNSP |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC STRIP PASTE
|
Facility
|
IP
|
$4.50
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna Commercial |
$4.05
|
| Rate for Payer: ASR ASR |
$4.37
|
| Rate for Payer: ASR Commercial |
$4.37
|
| Rate for Payer: BCBS Trust/PPO |
$3.67
|
| Rate for Payer: BCN Commercial |
$3.49
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.60
|
| Rate for Payer: Healthscope Commercial |
$4.50
|
| Rate for Payer: Healthscope Whirlpool |
$4.37
|
| Rate for Payer: Mclaren Commercial |
$4.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.83
|
| Rate for Payer: Nomi Health Commercial |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.96
|
|
|
HC STRIP PASTE
|
Facility
|
OP
|
$4.50
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna Commercial |
$4.05
|
| Rate for Payer: Aetna Medicare |
$2.25
|
| Rate for Payer: ASR ASR |
$4.37
|
| Rate for Payer: ASR Commercial |
$4.37
|
| Rate for Payer: BCBS Complete |
$1.80
|
| Rate for Payer: BCBS Trust/PPO |
$3.69
|
| Rate for Payer: BCN Commercial |
$3.49
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.60
|
| Rate for Payer: Healthscope Commercial |
$4.50
|
| Rate for Payer: Healthscope Whirlpool |
$4.37
|
| Rate for Payer: Mclaren Commercial |
$4.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.83
|
| Rate for Payer: Nomi Health Commercial |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.94
|
| Rate for Payer: Priority Health Narrow Network |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.96
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$87.31
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$87.31 |
| Rate for Payer: Aetna Commercial |
$78.58
|
| Rate for Payer: Aetna Medicare |
$13.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: ASR ASR |
$84.69
|
| Rate for Payer: ASR Commercial |
$84.69
|
| Rate for Payer: BCBS Complete |
$7.32
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$71.50
|
| Rate for Payer: BCN Commercial |
$67.69
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$82.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$87.31
|
| Rate for Payer: Healthscope Whirlpool |
$84.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.01
|
| Rate for Payer: Mclaren Commercial |
$78.58
|
| Rate for Payer: Mclaren Medicaid |
$6.97
|
| Rate for Payer: Mclaren Medicare |
$13.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.21
|
| Rate for Payer: Nomi Health Commercial |
$71.59
|
| Rate for Payer: PACE Medicare |
$12.36
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: PHP Medicaid |
$6.97
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.50
|
| Rate for Payer: Priority Health Medicare |
$13.01
|
| Rate for Payer: Priority Health Narrow Network |
$61.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$20.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP DNSP |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$6.97
|
| Rate for Payer: VA VA |
$13.01
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$87.31
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.75 |
| Max. Negotiated Rate |
$87.31 |
| Rate for Payer: Aetna Commercial |
$78.58
|
| Rate for Payer: ASR ASR |
$84.69
|
| Rate for Payer: ASR Commercial |
$84.69
|
| Rate for Payer: BCBS Trust/PPO |
$71.15
|
| Rate for Payer: BCN Commercial |
$67.69
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$82.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.85
|
| Rate for Payer: Healthscope Commercial |
$87.31
|
| Rate for Payer: Healthscope Whirlpool |
$84.69
|
| Rate for Payer: Mclaren Commercial |
$78.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.21
|
| Rate for Payer: Nomi Health Commercial |
$71.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.83
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$37.83
|
| Rate for Payer: ASR Commercial |
$37.83
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$31.94
|
| Rate for Payer: BCN Commercial |
$30.24
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$39.00
|
| Rate for Payer: Healthscope Whirlpool |
$37.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$35.10
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.17
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$27.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: ASR ASR |
$37.83
|
| Rate for Payer: ASR Commercial |
$37.83
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.24
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$39.00
|
| Rate for Payer: Healthscope Whirlpool |
$37.83
|
| Rate for Payer: Mclaren Commercial |
$35.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.32
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
IP
|
$132.60
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$86.19 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$119.34
|
| Rate for Payer: ASR ASR |
$128.62
|
| Rate for Payer: ASR Commercial |
$128.62
|
| Rate for Payer: BCBS Trust/PPO |
$108.06
|
| Rate for Payer: BCN Commercial |
$102.80
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$124.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Healthscope Commercial |
$132.60
|
| Rate for Payer: Healthscope Whirlpool |
$128.62
|
| Rate for Payer: Mclaren Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.71
|
| Rate for Payer: Nomi Health Commercial |
$108.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.69
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
OP
|
$132.60
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$119.34
|
| Rate for Payer: Aetna Medicare |
$8.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: ASR ASR |
$128.62
|
| Rate for Payer: ASR Commercial |
$128.62
|
| Rate for Payer: BCBS Complete |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$8.02
|
| Rate for Payer: BCBS Trust/PPO |
$108.59
|
| Rate for Payer: BCN Commercial |
$102.80
|
| Rate for Payer: BCN Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$124.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.02
|
| Rate for Payer: Healthscope Commercial |
$132.60
|
| Rate for Payer: Healthscope Whirlpool |
$128.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.02
|
| Rate for Payer: Mclaren Commercial |
$119.34
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Mclaren Medicare |
$8.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.42
|
| Rate for Payer: Meridian Medicaid |
$4.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.71
|
| Rate for Payer: Nomi Health Commercial |
$108.73
|
| Rate for Payer: PACE Medicare |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.02
|
| Rate for Payer: PHP Commercial |
$8.82
|
| Rate for Payer: PHP Medicaid |
$4.30
|
| Rate for Payer: PHP Medicare Advantage |
$8.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.18
|
| Rate for Payer: Priority Health Medicare |
$8.02
|
| Rate for Payer: Priority Health Narrow Network |
$92.95
|
| Rate for Payer: Railroad Medicare Medicare |
$8.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.02
|
| Rate for Payer: UHC Exchange |
$12.43
|
| Rate for Payer: UHC Medicare Advantage |
$8.02
|
| Rate for Payer: UHCCP DNSP |
$8.02
|
| Rate for Payer: UHCCP Medicaid |
$4.30
|
| Rate for Payer: VA VA |
$8.02
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
OP
|
$8,109.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,109.00 |
| Rate for Payer: Aetna Commercial |
$7,298.10
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,865.73
|
| Rate for Payer: ASR Commercial |
$7,865.73
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,640.46
|
| Rate for Payer: BCN Commercial |
$6,286.91
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$7,622.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,109.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,865.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,298.10
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,105.11
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,684.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,135.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
IP
|
$8,109.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,270.85 |
| Max. Negotiated Rate |
$8,109.00 |
| Rate for Payer: Aetna Commercial |
$7,298.10
|
| Rate for Payer: ASR ASR |
$7,865.73
|
| Rate for Payer: ASR Commercial |
$7,865.73
|
| Rate for Payer: BCBS Trust/PPO |
$6,608.02
|
| Rate for Payer: BCN Commercial |
$6,286.91
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$7,622.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Healthscope Commercial |
$8,109.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,865.73
|
| Rate for Payer: Mclaren Commercial |
$7,298.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,135.92
|
|
