|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$14.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.73
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$7.79
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.18
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$14.18
|
| 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 |
$7.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| 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 |
$7.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.89
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$63.92
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.18
|
| Rate for Payer: UHC Exchange |
$21.98
|
| Rate for Payer: UHC Medicaid |
$7.42
|
| Rate for Payer: UHCCP DNSP |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$7.42
|
| Rate for Payer: VA VA |
$14.18
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.64 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: BCBS Trust/PPO |
$102.53
|
| Rate for Payer: BCN Commercial |
$102.53
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$121.10
|
| Rate for Payer: Healthscope Whirlpool |
$124.85
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$124.85 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.15
|
| Rate for Payer: ASR ASR |
$121.10
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.72
|
| Rate for Payer: BCBS Trust/PPO |
$102.94
|
| Rate for Payer: BCN Commercial |
$102.94
|
| Rate for Payer: BCN Medicare Advantage |
$13.72
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.72
|
| Rate for Payer: Healthscope Commercial |
$121.10
|
| Rate for Payer: Healthscope Whirlpool |
$124.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.72
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$13.72
|
| Rate for Payer: Mclaren Medicare |
$13.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.41
|
| Rate for Payer: Meridian Medicaid |
$7.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.64
|
| Rate for Payer: PACE Medicare |
$13.03
|
| Rate for Payer: PACE SWMI |
$13.72
|
| Rate for Payer: PHP Commercial |
$15.09
|
| Rate for Payer: PHP Medicaid |
$7.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$109.39
|
| Rate for Payer: Priority Health Medicare |
$13.72
|
| Rate for Payer: Priority Health Narrow Network |
$87.52
|
| Rate for Payer: Railroad Medicare Medicare |
$13.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.72
|
| Rate for Payer: UHC Exchange |
$21.27
|
| Rate for Payer: UHC Medicaid |
$7.18
|
| Rate for Payer: UHCCP DNSP |
$13.72
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: VA VA |
$13.72
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial |
$82.40
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: ASR ASR |
$88.81
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$75.49
|
| Rate for Payer: BCN Commercial |
$75.49
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$86.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$88.81
|
| Rate for Payer: Healthscope Whirlpool |
$91.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$82.40
|
| Rate for Payer: Mclaren Medicaid |
$15.50
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.27
|
| Rate for Payer: Meridian Medicaid |
$8.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.67
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicaid |
$8.31
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.89
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$63.92
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.50
|
| Rate for Payer: UHC Exchange |
$24.02
|
| Rate for Payer: UHC Medicaid |
$8.11
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.11
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.67 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial |
$82.40
|
| Rate for Payer: ASR ASR |
$88.81
|
| Rate for Payer: BCBS Trust/PPO |
$75.19
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$86.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$88.81
|
| Rate for Payer: Healthscope Whirlpool |
$91.56
|
| Rate for Payer: Mclaren Commercial |
$82.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.57
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: ASR ASR |
$50.44
|
| Rate for Payer: BCBS Trust/PPO |
$42.70
|
| Rate for Payer: BCN Commercial |
$42.70
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$48.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Healthscope Whirlpool |
$52.00
|
| Rate for Payer: Mclaren Commercial |
$46.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.76
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: Aetna Medicare |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: ASR ASR |
$50.44
|
| Rate for Payer: BCBS Complete |
$12.31
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$42.87
|
| Rate for Payer: BCN Commercial |
$42.87
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$48.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Healthscope Whirlpool |
$52.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.41
|
| Rate for Payer: Mclaren Commercial |
$46.80
|
| Rate for Payer: Mclaren Medicaid |
$22.41
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: Meridian Medicaid |
$12.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Medicaid |
$12.01
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$45.56
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$36.45
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.41
|
| Rate for Payer: UHC Exchange |
$34.74
|
| Rate for Payer: UHC Medicaid |
$11.72
|
| Rate for Payer: UHCCP DNSP |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$11.72
|
| Rate for Payer: VA VA |
$22.41
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.67 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: BCBS Trust/PPO |
$40.16
|
| Rate for Payer: BCN Commercial |
$40.16
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Whirlpool |
$48.90
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$40.32
|
| Rate for Payer: BCN Commercial |
$40.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Whirlpool |
$48.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Mclaren Medicaid |
$15.50
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.27
|
| Rate for Payer: Meridian Medicaid |
$8.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicaid |
$8.31
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.89
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$63.92
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.50
|
| Rate for Payer: UHC Exchange |
$24.02
|
| Rate for Payer: UHC Medicaid |
$8.11
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.11
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.67 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: BCBS Trust/PPO |
$40.16
|
| Rate for Payer: BCN Commercial |
$40.16
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Whirlpool |
$48.90
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
|
|
HC VMA URINE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$40.32
|
| Rate for Payer: BCN Commercial |
$40.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Whirlpool |
$48.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Mclaren Medicaid |
$15.50
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.27
|
| Rate for Payer: Meridian Medicaid |
$8.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicaid |
$8.31
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.89
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$63.92
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.50
|
| Rate for Payer: UHC Exchange |
$24.02
|
| Rate for Payer: UHC Medicaid |
$8.11
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.11
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$5,229.68
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,922.26 |
| Max. Negotiated Rate |
$5,229.68 |
| Rate for Payer: Aetna Commercial |
$4,706.71
|
| Rate for Payer: ASR ASR |
$5,072.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,294.61
|
| Rate for Payer: BCN Commercial |
$4,294.61
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cofinity Commercial |
$4,915.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,183.74
|
| Rate for Payer: Healthscope Commercial |
$5,072.79
|
| Rate for Payer: Healthscope Whirlpool |
$5,229.68
|
| Rate for Payer: Mclaren Commercial |
$4,706.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,445.23
|
| Rate for Payer: Nomi Health Commercial |
$4,288.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,922.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,602.12
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$5,229.68
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$5,229.68 |
| Rate for Payer: Aetna Commercial |
$4,706.71
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$5,072.79
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,311.87
|
| Rate for Payer: BCN Commercial |
$4,311.87
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cofinity Commercial |
$4,915.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,183.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$5,072.79
|
| Rate for Payer: Healthscope Whirlpool |
$5,229.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$4,706.71
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,445.23
|
| Rate for Payer: Nomi Health Commercial |
$4,288.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,922.26
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,582.25
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,666.01
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,602.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,555.24
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$945.44 |
| Max. Negotiated Rate |
$2,555.24 |
| Rate for Payer: Aetna Commercial |
$2,299.72
|
| Rate for Payer: Aetna Medicare |
$945.44
|
| Rate for Payer: ASR ASR |
$2,478.58
|
| Rate for Payer: BCBS Complete |
$1,022.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.80
|
| Rate for Payer: BCN Commercial |
$2,106.80
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cofinity Commercial |
$2,401.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.19
|
| Rate for Payer: Healthscope Commercial |
$2,478.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,555.24
|
| Rate for Payer: Mclaren Commercial |
$2,299.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,044.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,171.95
|
| Rate for Payer: Nomi Health Commercial |
$2,095.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,238.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,791.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,248.61
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,555.24
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,916.43 |
| Max. Negotiated Rate |
$2,555.24 |
| Rate for Payer: Aetna Commercial |
$2,299.72
|
| Rate for Payer: ASR ASR |
$2,478.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,098.36
|
| Rate for Payer: BCN Commercial |
$2,098.36
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cofinity Commercial |
$2,401.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.19
|
| Rate for Payer: Healthscope Commercial |
$2,478.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,555.24
|
| Rate for Payer: Mclaren Commercial |
$2,299.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,171.95
|
| Rate for Payer: Nomi Health Commercial |
$2,095.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,248.61
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$267.46
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$200.59 |
| Max. Negotiated Rate |
$267.46 |
| Rate for Payer: Aetna Commercial |
$240.71
|
| Rate for Payer: ASR ASR |
$259.44
|
| Rate for Payer: BCBS Trust/PPO |
$219.64
|
| Rate for Payer: BCN Commercial |
$219.64
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$251.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.97
|
| Rate for Payer: Healthscope Commercial |
$259.44
|
| Rate for Payer: Healthscope Whirlpool |
$267.46
|
| Rate for Payer: Mclaren Commercial |
$240.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.34
|
| Rate for Payer: Nomi Health Commercial |
$219.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.36
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$267.46
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$98.96 |
| Max. Negotiated Rate |
$267.46 |
| Rate for Payer: Aetna Commercial |
$240.71
|
| Rate for Payer: Aetna Medicare |
$98.96
|
| Rate for Payer: ASR ASR |
$259.44
|
| Rate for Payer: BCBS Complete |
$106.98
|
| Rate for Payer: BCBS Trust/PPO |
$220.52
|
| Rate for Payer: BCN Commercial |
$220.52
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$251.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.97
|
| Rate for Payer: Healthscope Commercial |
$259.44
|
| Rate for Payer: Healthscope Whirlpool |
$267.46
|
| Rate for Payer: Mclaren Commercial |
$240.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.34
|
| Rate for Payer: Nomi Health Commercial |
$219.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$234.35
|
| Rate for Payer: Priority Health Narrow Network |
$187.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.36
|
|
|
HC VOLARA SUPPLY
|
Facility
|
IP
|
$284.58
|
|
| Hospital Charge Code |
27000712
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$213.44 |
| Max. Negotiated Rate |
$284.58 |
| Rate for Payer: Aetna Commercial |
$256.12
|
| Rate for Payer: ASR ASR |
$276.04
|
| Rate for Payer: BCBS Trust/PPO |
$233.70
|
| Rate for Payer: BCN Commercial |
$233.70
|
| Rate for Payer: Cash Price |
$227.66
|
| Rate for Payer: Cofinity Commercial |
$267.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.66
|
| Rate for Payer: Healthscope Commercial |
$276.04
|
| Rate for Payer: Healthscope Whirlpool |
$284.58
|
| Rate for Payer: Mclaren Commercial |
$256.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.89
|
| Rate for Payer: Nomi Health Commercial |
$233.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.43
|
|
|
HC VOLARA SUPPLY
|
Facility
|
OP
|
$284.58
|
|
| Hospital Charge Code |
27000712
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.29 |
| Max. Negotiated Rate |
$284.58 |
| Rate for Payer: Aetna Commercial |
$256.12
|
| Rate for Payer: Aetna Medicare |
$105.29
|
| Rate for Payer: ASR ASR |
$276.04
|
| Rate for Payer: BCBS Complete |
$113.83
|
| Rate for Payer: BCBS Trust/PPO |
$234.64
|
| Rate for Payer: BCN Commercial |
$234.64
|
| Rate for Payer: Cash Price |
$227.66
|
| Rate for Payer: Cofinity Commercial |
$267.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.66
|
| Rate for Payer: Healthscope Commercial |
$276.04
|
| Rate for Payer: Healthscope Whirlpool |
$284.58
|
| Rate for Payer: Mclaren Commercial |
$256.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.89
|
| Rate for Payer: Nomi Health Commercial |
$233.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$249.35
|
| Rate for Payer: Priority Health Narrow Network |
$199.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.43
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$20.06
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$3.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: ASR ASR |
$19.46
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.54
|
| Rate for Payer: BCN Commercial |
$16.54
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Commercial |
$18.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$19.46
|
| Rate for Payer: Healthscope Whirlpool |
$20.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.64
|
| Rate for Payer: Mclaren Commercial |
$18.05
|
| Rate for Payer: Mclaren Medicaid |
$3.64
|
| Rate for Payer: Mclaren Medicare |
$3.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$2.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: PACE Medicare |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$4.00
|
| Rate for Payer: PHP Medicaid |
$1.95
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.89
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow Network |
$8.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.64
|
| Rate for Payer: UHC Exchange |
$5.64
|
| Rate for Payer: UHC Medicaid |
$1.90
|
| Rate for Payer: UHCCP DNSP |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$1.90
|
| Rate for Payer: VA VA |
$3.64
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$20.06
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$15.04 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: ASR ASR |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$16.47
|
| Rate for Payer: BCN Commercial |
$16.47
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Commercial |
$18.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Healthscope Commercial |
$19.46
|
| Rate for Payer: Healthscope Whirlpool |
$20.06
|
| Rate for Payer: Mclaren Commercial |
$18.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.65
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$68.98 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Trust/PPO |
$56.65
|
| Rate for Payer: BCN Commercial |
$56.65
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$217.90 |
| Rate for Payer: Aetna Commercial |
$62.08
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$66.91
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$56.87
|
| Rate for Payer: BCN Commercial |
$56.87
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.90
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$174.32
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$189.11
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$203.82
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$173.24
|
| Rate for Payer: BCN Commercial |
$173.24
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$203.82
|
| Rate for Payer: Healthscope Whirlpool |
$210.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$189.11
|
| Rate for Payer: Mclaren Medicaid |
$30.86
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$16.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.59
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.11
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$147.29
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$157.59 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$189.11
|
| Rate for Payer: ASR ASR |
$203.82
|
| Rate for Payer: BCBS Trust/PPO |
$172.55
|
| Rate for Payer: BCN Commercial |
$172.55
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Healthscope Commercial |
$203.82
|
| Rate for Payer: Healthscope Whirlpool |
$210.12
|
| Rate for Payer: Mclaren Commercial |
$189.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.91
|
|
