|
HC URETERAL DILITATION CATH
|
Facility
|
IP
|
$356.73
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.87 |
| Max. Negotiated Rate |
$356.73 |
| Rate for Payer: Aetna Commercial |
$321.06
|
| Rate for Payer: ASR ASR |
$346.03
|
| Rate for Payer: ASR Commercial |
$346.03
|
| Rate for Payer: BCBS Trust/PPO |
$290.70
|
| Rate for Payer: BCN Commercial |
$276.57
|
| Rate for Payer: Cash Price |
$285.38
|
| Rate for Payer: Cofinity Commercial |
$335.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.38
|
| Rate for Payer: Healthscope Commercial |
$356.73
|
| Rate for Payer: Healthscope Whirlpool |
$346.03
|
| Rate for Payer: Mclaren Commercial |
$321.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.22
|
| Rate for Payer: Nomi Health Commercial |
$292.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.92
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
OP
|
$356.73
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$356.73 |
| Rate for Payer: Aetna Commercial |
$321.06
|
| Rate for Payer: Aetna Medicare |
$178.37
|
| Rate for Payer: ASR ASR |
$346.03
|
| Rate for Payer: ASR Commercial |
$346.03
|
| Rate for Payer: BCBS Complete |
$142.69
|
| Rate for Payer: BCBS Trust/PPO |
$292.13
|
| Rate for Payer: BCN Commercial |
$276.57
|
| Rate for Payer: Cash Price |
$285.38
|
| Rate for Payer: Cofinity Commercial |
$335.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.38
|
| Rate for Payer: Healthscope Commercial |
$356.73
|
| Rate for Payer: Healthscope Whirlpool |
$346.03
|
| Rate for Payer: Mclaren Commercial |
$321.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.22
|
| Rate for Payer: Nomi Health Commercial |
$292.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.57
|
| Rate for Payer: Priority Health Narrow Network |
$250.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.92
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$31.50
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: Aetna Medicare |
$5.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.35
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Complete |
$2.86
|
| Rate for Payer: BCBS MAPPO |
$5.08
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: BCN Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.08
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.08
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$2.72
|
| Rate for Payer: Mclaren Medicare |
$5.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.33
|
| Rate for Payer: Meridian Medicaid |
$2.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Medicare |
$4.83
|
| Rate for Payer: PACE SWMI |
$5.08
|
| Rate for Payer: PHP Commercial |
$5.59
|
| Rate for Payer: PHP Medicaid |
$2.72
|
| Rate for Payer: PHP Medicare Advantage |
$5.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.87
|
| Rate for Payer: Priority Health Medicare |
$5.08
|
| Rate for Payer: Priority Health Narrow Network |
$27.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.08
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$5.08
|
| Rate for Payer: UHCCP DNSP |
$5.08
|
| Rate for Payer: UHCCP Medicaid |
$2.72
|
| Rate for Payer: VA VA |
$5.08
|
|
|
HC URIC ACID SERUM
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| 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 URIC ACID SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.54
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| 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 |
$4.52
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.52
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.42
|
| Rate for Payer: Mclaren Medicare |
$4.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$2.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PHP Commercial |
$4.97
|
| Rate for Payer: PHP Medicaid |
$2.42
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.42
|
| 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 |
$4.52
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.52
|
| Rate for Payer: UHC Exchange |
$7.01
|
| Rate for Payer: UHC Medicare Advantage |
$4.52
|
| Rate for Payer: UHCCP DNSP |
$4.52
|
| Rate for Payer: UHCCP Medicaid |
$2.42
|
| Rate for Payer: VA VA |
$4.52
|
|
|
HC URINALYSIS
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.96
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| 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 |
$3.17
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.17
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$1.70
|
| Rate for Payer: Mclaren Medicare |
$3.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: Meridian Medicaid |
$1.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$3.01
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Commercial |
$3.49
|
| Rate for Payer: PHP Medicaid |
$1.70
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.70
|
| 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 |
$3.17
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$3.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.17
|
| Rate for Payer: UHC Exchange |
$4.91
|
| Rate for Payer: UHC Medicare Advantage |
$3.17
|
| Rate for Payer: UHCCP DNSP |
$3.17
|
| Rate for Payer: UHCCP Medicaid |
$1.70
|
| Rate for Payer: VA VA |
$3.17
|
|
|
HC URINALYSIS
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| 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 URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: Aetna Medicare |
$3.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Complete |
$1.72
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.05
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$1.63
|
| Rate for Payer: Mclaren Medicare |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Medicaid |
$1.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Medicare |
$2.90
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Commercial |
$3.35
|
| Rate for Payer: PHP Medicaid |
$1.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.87
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$27.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Exchange |
$4.73
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
| Rate for Payer: UHCCP DNSP |
$3.05
|
| Rate for Payer: UHCCP Medicaid |
$1.63
|
| Rate for Payer: VA VA |
$3.05
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$31.50
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
OP
|
$14.06
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Medicare |
$7.03
|
| Rate for Payer: ASR ASR |
$13.64
|
| Rate for Payer: ASR Commercial |
$13.64
|
| Rate for Payer: BCBS Complete |
$5.62
|
| Rate for Payer: BCBS Trust/PPO |
$11.51
|
| Rate for Payer: BCN Commercial |
$10.90
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.25
|
| Rate for Payer: Healthscope Commercial |
$14.06
|
| Rate for Payer: Healthscope Whirlpool |
$13.64
|
| Rate for Payer: Mclaren Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.95
|
| Rate for Payer: Nomi Health Commercial |
$11.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.37
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
IP
|
$14.06
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: ASR ASR |
$13.64
|
| Rate for Payer: ASR Commercial |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$10.90
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.25
|
| Rate for Payer: Healthscope Commercial |
$14.06
|
| Rate for Payer: Healthscope Whirlpool |
$13.64
|
| Rate for Payer: Mclaren Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.95
|
| Rate for Payer: Nomi Health Commercial |
$11.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.37
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$96.32 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| 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 |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.41
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| 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 |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| 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 |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.83
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
| 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 URINE ALCOHOL SCRN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Trust/PPO |
$77.03
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$15.81
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: ASR Commercial |
$30.67
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.71
|
| Rate for Payer: Priority Health Narrow Network |
$22.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: ASR Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$25.77
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
|
HC URINE CULTURE
|
Facility
|
OP
|
$40.08
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$40.08 |
| Rate for Payer: Aetna Commercial |
$36.07
|
| Rate for Payer: Aetna Medicare |
$8.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.09
|
| Rate for Payer: ASR ASR |
$38.88
|
| Rate for Payer: ASR Commercial |
$38.88
|
| Rate for Payer: BCBS Complete |
$4.54
|
| Rate for Payer: BCBS MAPPO |
$8.07
|
| Rate for Payer: BCBS Trust/PPO |
$32.82
|
| Rate for Payer: BCN Commercial |
$31.07
|
| Rate for Payer: BCN Medicare Advantage |
$8.07
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cofinity Commercial |
$37.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.07
|
| Rate for Payer: Healthscope Commercial |
$40.08
|
| Rate for Payer: Healthscope Whirlpool |
$38.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.07
|
| Rate for Payer: Mclaren Commercial |
$36.07
|
| Rate for Payer: Mclaren Medicaid |
$4.33
|
| Rate for Payer: Mclaren Medicare |
$8.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Meridian Medicaid |
$4.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.07
|
| Rate for Payer: Nomi Health Commercial |
$32.87
|
| Rate for Payer: PACE Medicare |
$7.67
|
| Rate for Payer: PACE SWMI |
$8.07
|
| Rate for Payer: PHP Commercial |
$8.88
|
| Rate for Payer: PHP Medicaid |
$4.33
|
| Rate for Payer: PHP Medicare Advantage |
$8.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.12
|
| Rate for Payer: Priority Health Medicare |
$8.07
|
| Rate for Payer: Priority Health Narrow Network |
$28.10
|
| Rate for Payer: Railroad Medicare Medicare |
$8.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.07
|
| Rate for Payer: UHC Exchange |
$12.51
|
| Rate for Payer: UHC Medicare Advantage |
$8.07
|
| Rate for Payer: UHCCP DNSP |
$8.07
|
| Rate for Payer: UHCCP Medicaid |
$4.33
|
| Rate for Payer: VA VA |
$8.07
|
|
|
HC URINE CULTURE
|
Facility
|
IP
|
$40.08
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.05 |
| Max. Negotiated Rate |
$40.08 |
| Rate for Payer: Aetna Commercial |
$36.07
|
| Rate for Payer: ASR ASR |
$38.88
|
| Rate for Payer: ASR Commercial |
$38.88
|
| Rate for Payer: BCBS Trust/PPO |
$32.66
|
| Rate for Payer: BCN Commercial |
$31.07
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cofinity Commercial |
$37.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.06
|
| Rate for Payer: Healthscope Commercial |
$40.08
|
| Rate for Payer: Healthscope Whirlpool |
$38.88
|
| Rate for Payer: Mclaren Commercial |
$36.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.07
|
| Rate for Payer: Nomi Health Commercial |
$32.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.27
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
OP
|
$25.27
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$26.57 |
| Rate for Payer: Aetna Commercial |
$22.74
|
| Rate for Payer: Aetna Medicare |
$17.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.43
|
| Rate for Payer: ASR ASR |
$24.51
|
| Rate for Payer: ASR Commercial |
$24.51
|
| Rate for Payer: BCBS Complete |
$9.65
|
| Rate for Payer: BCBS MAPPO |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: BCN Medicare Advantage |
$17.14
|
| Rate for Payer: Cash Price |
$20.22
|
| Rate for Payer: Cash Price |
$20.22
|
| Rate for Payer: Cofinity Commercial |
$23.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$25.27
|
| Rate for Payer: Healthscope Whirlpool |
$24.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.14
|
| Rate for Payer: Mclaren Commercial |
$22.74
|
| Rate for Payer: Mclaren Medicaid |
$9.19
|
| Rate for Payer: Mclaren Medicare |
$17.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.00
|
| Rate for Payer: Meridian Medicaid |
$9.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.48
|
| Rate for Payer: Nomi Health Commercial |
$20.72
|
| Rate for Payer: PACE Medicare |
$16.28
|
| Rate for Payer: PACE SWMI |
$17.14
|
| Rate for Payer: PHP Commercial |
$18.85
|
| Rate for Payer: PHP Medicaid |
$9.19
|
| Rate for Payer: PHP Medicare Advantage |
$17.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.14
|
| Rate for Payer: Priority Health Medicare |
$17.14
|
| Rate for Payer: Priority Health Narrow Network |
$17.71
|
| Rate for Payer: Railroad Medicare Medicare |
$17.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.14
|
| Rate for Payer: UHC Exchange |
$26.57
|
| Rate for Payer: UHC Medicare Advantage |
$17.14
|
| Rate for Payer: UHCCP DNSP |
$17.14
|
| Rate for Payer: UHCCP Medicaid |
$9.19
|
| Rate for Payer: VA VA |
$17.14
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
IP
|
$25.27
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$25.27 |
| Rate for Payer: Aetna Commercial |
$22.74
|
| Rate for Payer: ASR ASR |
$24.51
|
| Rate for Payer: ASR Commercial |
$24.51
|
| Rate for Payer: BCBS Trust/PPO |
$20.59
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: Cash Price |
$20.22
|
| Rate for Payer: Cofinity Commercial |
$23.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.22
|
| Rate for Payer: Healthscope Commercial |
$25.27
|
| Rate for Payer: Healthscope Whirlpool |
$24.51
|
| Rate for Payer: Mclaren Commercial |
$22.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.48
|
| Rate for Payer: Nomi Health Commercial |
$20.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.24
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: Aetna Medicare |
$31.62
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS Trust/PPO |
$51.79
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.76
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.61
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$4.61
|
| Rate for Payer: Mclaren Medicare |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$8.18
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Commercial |
$9.47
|
| Rate for Payer: PHP Medicaid |
$4.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Exchange |
$13.35
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
| Rate for Payer: UHCCP DNSP |
$8.61
|
| Rate for Payer: UHCCP Medicaid |
$4.61
|
| Rate for Payer: VA VA |
$8.61
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
OP
|
$65.08
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$65.08 |
| Rate for Payer: Aetna Commercial |
$58.57
|
| Rate for Payer: Aetna Medicare |
$8.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.11
|
| Rate for Payer: ASR ASR |
$63.13
|
| Rate for Payer: ASR Commercial |
$63.13
|
| Rate for Payer: BCBS Complete |
$4.55
|
| Rate for Payer: BCBS MAPPO |
$8.09
|
| Rate for Payer: BCBS Trust/PPO |
$53.29
|
| Rate for Payer: BCN Commercial |
$50.46
|
| Rate for Payer: BCN Medicare Advantage |
$8.09
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cash Price |
$52.06
|
| Rate for Payer: Cofinity Commercial |
$61.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.09
|
| Rate for Payer: Healthscope Commercial |
$65.08
|
| Rate for Payer: Healthscope Whirlpool |
$63.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.09
|
| Rate for Payer: Mclaren Commercial |
$58.57
|
| Rate for Payer: Mclaren Medicaid |
$4.34
|
| Rate for Payer: Mclaren Medicare |
$8.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.49
|
| Rate for Payer: Meridian Medicaid |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.32
|
| Rate for Payer: Nomi Health Commercial |
$53.37
|
| Rate for Payer: PACE Medicare |
$7.69
|
| Rate for Payer: PACE SWMI |
$8.09
|
| Rate for Payer: PHP Commercial |
$8.90
|
| Rate for Payer: PHP Medicaid |
$4.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.02
|
| Rate for Payer: Priority Health Medicare |
$8.09
|
| Rate for Payer: Priority Health Narrow Network |
$45.62
|
| Rate for Payer: Railroad Medicare Medicare |
$8.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.09
|
| Rate for Payer: UHC Exchange |
$12.54
|
| Rate for Payer: UHC Medicare Advantage |
$8.09
|
| Rate for Payer: UHCCP DNSP |
$8.09
|
| Rate for Payer: UHCCP Medicaid |
$4.34
|
| Rate for Payer: VA VA |
$8.09
|
|
