|
HC TOTAL PROTEIN FLUID
|
Facility
|
IP
|
$38.86
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$38.86 |
| Rate for Payer: Aetna Commercial |
$34.97
|
| Rate for Payer: ASR ASR |
$37.69
|
| Rate for Payer: ASR Commercial |
$37.69
|
| Rate for Payer: BCBS Trust/PPO |
$31.67
|
| Rate for Payer: BCN Commercial |
$30.13
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$36.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$38.86
|
| Rate for Payer: Healthscope Whirlpool |
$37.69
|
| Rate for Payer: Mclaren Commercial |
$34.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.20
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
OP
|
$38.86
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$38.86 |
| Rate for Payer: Aetna Commercial |
$34.97
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.00
|
| Rate for Payer: ASR ASR |
$37.69
|
| Rate for Payer: ASR Commercial |
$37.69
|
| Rate for Payer: BCBS Complete |
$2.25
|
| Rate for Payer: BCBS MAPPO |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$31.82
|
| Rate for Payer: BCN Commercial |
$30.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.00
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$36.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.00
|
| Rate for Payer: Healthscope Commercial |
$38.86
|
| Rate for Payer: Healthscope Whirlpool |
$37.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.00
|
| Rate for Payer: Mclaren Commercial |
$34.97
|
| Rate for Payer: Mclaren Medicaid |
$2.14
|
| Rate for Payer: Mclaren Medicare |
$4.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.20
|
| Rate for Payer: Meridian Medicaid |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE Medicare |
$3.80
|
| Rate for Payer: PACE SWMI |
$4.00
|
| Rate for Payer: PHP Commercial |
$4.40
|
| Rate for Payer: PHP Medicaid |
$2.14
|
| Rate for Payer: PHP Medicare Advantage |
$4.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.81
|
| Rate for Payer: Priority Health Medicare |
$4.00
|
| Rate for Payer: Priority Health Narrow Network |
$20.65
|
| Rate for Payer: Railroad Medicare Medicare |
$4.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.00
|
| Rate for Payer: UHC Exchange |
$6.20
|
| Rate for Payer: UHC Medicare Advantage |
$4.00
|
| Rate for Payer: UHCCP DNSP |
$4.00
|
| Rate for Payer: UHCCP Medicaid |
$2.14
|
| Rate for Payer: VA VA |
$4.00
|
|
|
HC TOTAL PROTEIN URINE
|
Facility
|
IP
|
$38.86
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$38.86 |
| Rate for Payer: Aetna Commercial |
$34.97
|
| Rate for Payer: ASR ASR |
$37.69
|
| Rate for Payer: ASR Commercial |
$37.69
|
| Rate for Payer: BCBS Trust/PPO |
$31.67
|
| Rate for Payer: BCN Commercial |
$30.13
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$36.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$38.86
|
| Rate for Payer: Healthscope Whirlpool |
$37.69
|
| Rate for Payer: Mclaren Commercial |
$34.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.20
|
|
|
HC TOTAL PROTEIN URINE
|
Facility
|
OP
|
$38.86
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$47.22 |
| Rate for Payer: Aetna Commercial |
$34.97
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.59
|
| Rate for Payer: ASR ASR |
$37.69
|
| Rate for Payer: ASR Commercial |
$37.69
|
| Rate for Payer: BCBS Complete |
$2.07
|
| Rate for Payer: BCBS MAPPO |
$3.67
|
| Rate for Payer: BCBS Trust/PPO |
$31.82
|
| Rate for Payer: BCN Commercial |
$30.13
|
| Rate for Payer: BCN Medicare Advantage |
$3.67
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cash Price |
$31.09
|
| Rate for Payer: Cofinity Commercial |
$36.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$38.86
|
| Rate for Payer: Healthscope Whirlpool |
$37.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.67
|
| Rate for Payer: Mclaren Commercial |
$34.97
|
| Rate for Payer: Mclaren Medicaid |
$1.97
|
| Rate for Payer: Mclaren Medicare |
$3.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$2.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.03
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE Medicare |
$3.49
|
| Rate for Payer: PACE SWMI |
$3.67
|
| Rate for Payer: PHP Commercial |
$4.04
|
| Rate for Payer: PHP Medicaid |
$1.97
|
| Rate for Payer: PHP Medicare Advantage |
$3.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.22
|
| Rate for Payer: Priority Health Medicare |
$3.67
|
| Rate for Payer: Priority Health Narrow Network |
$37.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.67
|
| Rate for Payer: UHC Exchange |
$5.69
|
| Rate for Payer: UHC Medicare Advantage |
$3.67
|
| Rate for Payer: UHCCP DNSP |
$3.67
|
| Rate for Payer: UHCCP Medicaid |
$1.97
|
| Rate for Payer: VA VA |
$3.67
|
|
|
HC TOTAL T3
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: ASR Commercial |
$46.33
|
| Rate for Payer: BCBS Trust/PPO |
$38.92
|
| Rate for Payer: BCN Commercial |
$37.03
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$47.76
|
| Rate for Payer: Healthscope Whirlpool |
$46.33
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
|
|
HC TOTAL T3
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare |
$14.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: ASR Commercial |
$46.33
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$39.11
|
| Rate for Payer: BCN Commercial |
$37.03
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$47.76
|
| Rate for Payer: Healthscope Whirlpool |
$46.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.18
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$7.60
|
| Rate for Payer: Mclaren Medicare |
$14.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: Meridian Medicaid |
$7.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: PACE Medicare |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$15.60
|
| Rate for Payer: PHP Medicaid |
$7.60
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.54
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$31.63
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Exchange |
$21.98
|
| Rate for Payer: UHC Medicare Advantage |
$14.18
|
| Rate for Payer: UHCCP DNSP |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$7.60
|
| Rate for Payer: VA VA |
$14.18
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$166.46 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$161.47
|
| Rate for Payer: ASR Commercial |
$161.47
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Commercial |
$129.06
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$156.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$166.46
|
| Rate for Payer: Healthscope Whirlpool |
$161.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$149.81
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| 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 |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| 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 |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.85
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$116.69
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$166.46 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: ASR ASR |
$161.47
|
| Rate for Payer: ASR Commercial |
$161.47
|
| Rate for Payer: BCBS Trust/PPO |
$135.65
|
| Rate for Payer: BCN Commercial |
$129.06
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$156.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$166.46
|
| Rate for Payer: Healthscope Whirlpool |
$161.47
|
| Rate for Payer: Mclaren Commercial |
$149.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.48
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$115.26 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: ASR ASR |
$111.80
|
| Rate for Payer: ASR Commercial |
$111.80
|
| Rate for Payer: BCBS Trust/PPO |
$93.93
|
| Rate for Payer: BCN Commercial |
$89.36
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$108.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$115.26
|
| Rate for Payer: Healthscope Whirlpool |
$111.80
|
| Rate for Payer: Mclaren Commercial |
$103.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.43
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$115.26 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| 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 |
$111.80
|
| Rate for Payer: ASR Commercial |
$111.80
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$94.39
|
| Rate for Payer: BCN Commercial |
$89.36
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$108.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$115.26
|
| Rate for Payer: Healthscope Whirlpool |
$111.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$103.73
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| 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 |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| 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 |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.82
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$34.26
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$22.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP DNSP |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$14.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.01
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$8.11
|
| Rate for Payer: BCBS MAPPO |
$14.41
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$14.41
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.41
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.41
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$7.72
|
| Rate for Payer: Mclaren Medicare |
$14.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.13
|
| Rate for Payer: Meridian Medicaid |
$8.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$13.69
|
| Rate for Payer: PACE SWMI |
$14.41
|
| Rate for Payer: PHP Commercial |
$15.85
|
| Rate for Payer: PHP Medicaid |
$7.72
|
| Rate for Payer: PHP Medicare Advantage |
$14.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.99
|
| Rate for Payer: Priority Health Medicare |
$14.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.79
|
| Rate for Payer: Railroad Medicare Medicare |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.41
|
| Rate for Payer: UHC Exchange |
$22.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.41
|
| Rate for Payer: UHCCP DNSP |
$14.41
|
| Rate for Payer: UHCCP Medicaid |
$7.72
|
| Rate for Payer: VA VA |
$14.41
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$249.87 |
| Max. Negotiated Rate |
$722.56 |
| Rate for Payer: Aetna Commercial |
$476.52
|
| Rate for Payer: Aetna Medicare |
$466.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.71
|
| Rate for Payer: ASR ASR |
$513.59
|
| Rate for Payer: ASR Commercial |
$513.59
|
| Rate for Payer: BCBS Complete |
$262.36
|
| Rate for Payer: BCBS MAPPO |
$466.17
|
| Rate for Payer: BCBS Trust/PPO |
$433.58
|
| Rate for Payer: BCN Commercial |
$410.50
|
| Rate for Payer: BCN Medicare Advantage |
$466.17
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$497.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.17
|
| Rate for Payer: Healthscope Commercial |
$529.47
|
| Rate for Payer: Healthscope Whirlpool |
$513.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$466.17
|
| Rate for Payer: Mclaren Commercial |
$476.52
|
| Rate for Payer: Mclaren Medicaid |
$249.87
|
| Rate for Payer: Mclaren Medicare |
$466.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.48
|
| Rate for Payer: Meridian Medicaid |
$262.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$434.17
|
| Rate for Payer: PACE Medicare |
$442.86
|
| Rate for Payer: PACE SWMI |
$466.17
|
| Rate for Payer: PHP Commercial |
$512.79
|
| Rate for Payer: PHP Medicaid |
$249.87
|
| Rate for Payer: PHP Medicare Advantage |
$466.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.72
|
| Rate for Payer: Priority Health Medicare |
$466.17
|
| Rate for Payer: Priority Health Narrow Network |
$426.98
|
| Rate for Payer: Railroad Medicare Medicare |
$466.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.17
|
| Rate for Payer: UHC Exchange |
$722.56
|
| Rate for Payer: UHC Medicare Advantage |
$466.17
|
| Rate for Payer: UHCCP DNSP |
$466.17
|
| Rate for Payer: UHCCP Medicaid |
$249.87
|
| Rate for Payer: VA VA |
$466.17
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$344.16 |
| Max. Negotiated Rate |
$529.47 |
| Rate for Payer: Aetna Commercial |
$476.52
|
| Rate for Payer: ASR ASR |
$513.59
|
| Rate for Payer: ASR Commercial |
$513.59
|
| Rate for Payer: BCBS Trust/PPO |
$431.47
|
| Rate for Payer: BCN Commercial |
$410.50
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$497.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Healthscope Commercial |
$529.47
|
| Rate for Payer: Healthscope Whirlpool |
$513.59
|
| Rate for Payer: Mclaren Commercial |
$476.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$434.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.93
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$119.73 |
| Max. Negotiated Rate |
$299.32 |
| Rate for Payer: Aetna Commercial |
$269.39
|
| Rate for Payer: Aetna Medicare |
$149.66
|
| Rate for Payer: ASR ASR |
$290.34
|
| Rate for Payer: ASR Commercial |
$290.34
|
| Rate for Payer: BCBS Complete |
$119.73
|
| Rate for Payer: BCBS Trust/PPO |
$245.11
|
| Rate for Payer: BCN Commercial |
$232.06
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$281.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$299.32
|
| Rate for Payer: Healthscope Whirlpool |
$290.34
|
| Rate for Payer: Mclaren Commercial |
$269.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: Nomi Health Commercial |
$245.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$262.26
|
| Rate for Payer: Priority Health Narrow Network |
$209.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.40
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$194.56 |
| Max. Negotiated Rate |
$299.32 |
| Rate for Payer: Aetna Commercial |
$269.39
|
| Rate for Payer: ASR ASR |
$290.34
|
| Rate for Payer: ASR Commercial |
$290.34
|
| Rate for Payer: BCBS Trust/PPO |
$243.92
|
| Rate for Payer: BCN Commercial |
$232.06
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$281.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$299.32
|
| Rate for Payer: Healthscope Whirlpool |
$290.34
|
| Rate for Payer: Mclaren Commercial |
$269.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: Nomi Health Commercial |
$245.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.40
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$861.90 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Commercial |
$1,193.40
|
| Rate for Payer: ASR ASR |
$1,286.22
|
| Rate for Payer: ASR Commercial |
$1,286.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.56
|
| Rate for Payer: BCN Commercial |
$1,028.05
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,246.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Healthscope Commercial |
$1,326.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,286.22
|
| Rate for Payer: Mclaren Commercial |
$1,193.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,087.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.88
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.44 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Commercial |
$1,193.40
|
| Rate for Payer: Aetna Medicare |
$498.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: ASR ASR |
$1,286.22
|
| Rate for Payer: ASR Commercial |
$1,286.22
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.86
|
| Rate for Payer: BCN Commercial |
$1,028.05
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,246.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,326.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,286.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$498.95
|
| Rate for Payer: Mclaren Commercial |
$1,193.40
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,087.32
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$548.84
|
| Rate for Payer: PHP Medicaid |
$267.44
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,161.84
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$929.53
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$773.37
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP DNSP |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: VA VA |
$498.95
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,244.33 |
| Max. Negotiated Rate |
$8,068.20 |
| Rate for Payer: Aetna Commercial |
$7,261.38
|
| Rate for Payer: ASR ASR |
$7,826.15
|
| Rate for Payer: ASR Commercial |
$7,826.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,574.78
|
| Rate for Payer: BCN Commercial |
$6,255.28
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$7,584.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Healthscope Commercial |
$8,068.20
|
| Rate for Payer: Healthscope Whirlpool |
$7,826.15
|
| Rate for Payer: Mclaren Commercial |
$7,261.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,615.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,100.02
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,703.14 |
| Max. Negotiated Rate |
$8,068.20 |
| Rate for Payer: Aetna Commercial |
$7,261.38
|
| Rate for Payer: Aetna Medicare |
$3,177.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: ASR ASR |
$7,826.15
|
| Rate for Payer: ASR Commercial |
$7,826.15
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,607.05
|
| Rate for Payer: BCN Commercial |
$6,255.28
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$7,584.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$8,068.20
|
| Rate for Payer: Healthscope Whirlpool |
$7,826.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,177.50
|
| Rate for Payer: Mclaren Commercial |
$7,261.38
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,615.92
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$3,495.25
|
| Rate for Payer: PHP Medicaid |
$1,703.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,069.36
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$5,655.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,100.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$4,925.12
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP DNSP |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$329.90 |
| Max. Negotiated Rate |
$507.54 |
| Rate for Payer: Aetna Commercial |
$456.79
|
| Rate for Payer: ASR ASR |
$492.31
|
| Rate for Payer: ASR Commercial |
$492.31
|
| Rate for Payer: BCBS Trust/PPO |
$413.59
|
| Rate for Payer: BCN Commercial |
$393.50
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$477.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$507.54
|
| Rate for Payer: Healthscope Whirlpool |
$492.31
|
| Rate for Payer: Mclaren Commercial |
$456.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: Nomi Health Commercial |
$416.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.64
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$203.02 |
| Max. Negotiated Rate |
$507.54 |
| Rate for Payer: Aetna Commercial |
$456.79
|
| Rate for Payer: Aetna Medicare |
$253.77
|
| Rate for Payer: ASR ASR |
$492.31
|
| Rate for Payer: ASR Commercial |
$492.31
|
| Rate for Payer: BCBS Complete |
$203.02
|
| Rate for Payer: BCBS Trust/PPO |
$415.62
|
| Rate for Payer: BCN Commercial |
$393.50
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$477.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$507.54
|
| Rate for Payer: Healthscope Whirlpool |
$492.31
|
| Rate for Payer: Mclaren Commercial |
$456.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: Nomi Health Commercial |
$416.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$444.71
|
| Rate for Payer: Priority Health Narrow Network |
$355.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.64
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.41 |
| Max. Negotiated Rate |
$177.56 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: ASR ASR |
$172.23
|
| Rate for Payer: ASR Commercial |
$172.23
|
| Rate for Payer: BCBS Trust/PPO |
$144.69
|
| Rate for Payer: BCN Commercial |
$137.66
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$166.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Healthscope Commercial |
$177.56
|
| Rate for Payer: Healthscope Whirlpool |
$172.23
|
| Rate for Payer: Mclaren Commercial |
$159.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$145.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.25
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.41 |
| Max. Negotiated Rate |
$414.57 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna Medicare |
$227.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: ASR ASR |
$172.23
|
| Rate for Payer: ASR Commercial |
$172.23
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$145.40
|
| Rate for Payer: BCN Commercial |
$137.66
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$166.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$177.56
|
| Rate for Payer: Healthscope Whirlpool |
$172.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$227.52
|
| Rate for Payer: Mclaren Commercial |
$159.80
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$145.60
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$250.27
|
| Rate for Payer: PHP Medicaid |
$121.95
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.57
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$331.66
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$352.66
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP DNSP |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: VA VA |
$227.52
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$119.65 |
| Rate for Payer: Aetna Commercial |
$107.68
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Trust/PPO |
$97.50
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Mclaren Commercial |
$107.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
|
