|
HC VITAMIN B3 AND METABOLITES, P
|
Facility
|
OP
|
$188.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100754
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$188.45 |
| Rate for Payer: Aetna Commercial |
$169.60
|
| Rate for Payer: Aetna Medicare |
$17.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: ASR ASR |
$182.80
|
| Rate for Payer: ASR Commercial |
$182.80
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCBS Trust/PPO |
$154.32
|
| Rate for Payer: BCN Commercial |
$146.11
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$150.76
|
| Rate for Payer: Cash Price |
$150.76
|
| Rate for Payer: Cofinity Commercial |
$177.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$188.45
|
| Rate for Payer: Healthscope Whirlpool |
$182.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.06
|
| Rate for Payer: Mclaren Commercial |
$169.60
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.18
|
| Rate for Payer: Nomi Health Commercial |
$154.53
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$18.77
|
| Rate for Payer: PHP Medicaid |
$9.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.12
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow Network |
$132.10
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.06
|
| Rate for Payer: UHC Exchange |
$26.44
|
| Rate for Payer: UHC Medicare Advantage |
$17.06
|
| Rate for Payer: UHCCP DNSP |
$17.06
|
| Rate for Payer: UHCCP Medicaid |
$9.14
|
| Rate for Payer: VA VA |
$17.06
|
|
|
HC VITAMIN B6 LEVEL
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.06 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: Aetna Medicare |
$28.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.12
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Complete |
$15.81
|
| Rate for Payer: BCBS MAPPO |
$28.10
|
| Rate for Payer: BCBS Trust/PPO |
$46.86
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: BCN Medicare Advantage |
$28.10
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.10
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.10
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$15.06
|
| Rate for Payer: Mclaren Medicare |
$28.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.50
|
| Rate for Payer: Meridian Medicaid |
$15.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PACE Medicare |
$26.70
|
| Rate for Payer: PACE SWMI |
$28.10
|
| Rate for Payer: PHP Commercial |
$30.91
|
| Rate for Payer: PHP Medicaid |
$15.06
|
| Rate for Payer: PHP Medicare Advantage |
$28.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.14
|
| Rate for Payer: Priority Health Medicare |
$28.10
|
| Rate for Payer: Priority Health Narrow Network |
$40.11
|
| Rate for Payer: Railroad Medicare Medicare |
$28.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.10
|
| Rate for Payer: UHC Exchange |
$43.55
|
| Rate for Payer: UHC Medicare Advantage |
$28.10
|
| Rate for Payer: UHCCP DNSP |
$28.10
|
| Rate for Payer: UHCCP Medicaid |
$15.06
|
| Rate for Payer: VA VA |
$28.10
|
|
|
HC VITAMIN B6 LEVEL
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Trust/PPO |
$46.63
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$9.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.36
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$5.57
|
| Rate for Payer: BCBS MAPPO |
$9.89
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.89
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.89
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.89
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$5.30
|
| Rate for Payer: Mclaren Medicare |
$9.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.38
|
| Rate for Payer: Meridian Medicaid |
$5.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$9.40
|
| Rate for Payer: PACE SWMI |
$9.89
|
| Rate for Payer: PHP Commercial |
$10.88
|
| Rate for Payer: PHP Medicaid |
$5.30
|
| Rate for Payer: PHP Medicare Advantage |
$9.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.09
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: Priority Health Narrow Network |
$46.48
|
| Rate for Payer: Railroad Medicare Medicare |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.89
|
| Rate for Payer: UHC Exchange |
$15.33
|
| Rate for Payer: UHC Medicare Advantage |
$9.89
|
| Rate for Payer: UHCCP DNSP |
$9.89
|
| Rate for Payer: UHCCP Medicaid |
$5.30
|
| Rate for Payer: VA VA |
$9.89
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC VITAMIN D
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.87 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$16.66
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.60
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$15.87
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: Meridian Medicaid |
$16.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: PHP Medicaid |
$15.87
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.60
|
| Rate for Payer: UHC Exchange |
$45.88
|
| Rate for Payer: UHC Medicare Advantage |
$29.60
|
| Rate for Payer: UHCCP DNSP |
$29.60
|
| Rate for Payer: UHCCP Medicaid |
$15.87
|
| Rate for Payer: VA VA |
$29.60
|
|
|
HC VITAMIN D
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.87 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: ASR Commercial |
$90.83
|
| Rate for Payer: BCBS Trust/PPO |
$76.31
|
| Rate for Payer: BCN Commercial |
$72.60
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Healthscope Whirlpool |
$90.83
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: ASR Commercial |
$90.83
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$38.50
|
| Rate for Payer: BCBS Trust/PPO |
$76.68
|
| Rate for Payer: BCN Commercial |
$72.60
|
| Rate for Payer: BCN Medicare Advantage |
$38.50
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.50
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Healthscope Whirlpool |
$90.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.50
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$38.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: PACE Medicare |
$36.58
|
| Rate for Payer: PACE SWMI |
$38.50
|
| Rate for Payer: PHP Commercial |
$42.35
|
| Rate for Payer: PHP Medicaid |
$20.64
|
| Rate for Payer: PHP Medicare Advantage |
$38.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.05
|
| Rate for Payer: Priority Health Medicare |
$38.50
|
| Rate for Payer: Priority Health Narrow Network |
$65.64
|
| Rate for Payer: Railroad Medicare Medicare |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.50
|
| Rate for Payer: UHC Exchange |
$59.67
|
| Rate for Payer: UHC Medicare Advantage |
$38.50
|
| Rate for Payer: UHCCP DNSP |
$38.50
|
| Rate for Payer: UHCCP Medicaid |
$20.64
|
| Rate for Payer: VA VA |
$38.50
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.87 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$16.66
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.60
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$15.87
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: Meridian Medicaid |
$16.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: PHP Medicaid |
$15.87
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.60
|
| Rate for Payer: UHC Exchange |
$45.88
|
| Rate for Payer: UHC Medicare Advantage |
$29.60
|
| Rate for Payer: UHCCP DNSP |
$29.60
|
| Rate for Payer: UHCCP Medicaid |
$15.87
|
| Rate for Payer: VA VA |
$29.60
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| 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 |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.18
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| 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 |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| 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 |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| 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 VITAMIN E LEVEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.56 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| Rate for Payer: ASR ASR |
$118.73
|
| Rate for Payer: ASR Commercial |
$118.73
|
| Rate for Payer: BCBS Trust/PPO |
$99.74
|
| Rate for Payer: BCN Commercial |
$94.90
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Healthscope Whirlpool |
$118.73
|
| Rate for Payer: Mclaren Commercial |
$110.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.04
|
| Rate for Payer: Nomi Health Commercial |
$100.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.71
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| 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 |
$118.73
|
| Rate for Payer: ASR Commercial |
$118.73
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.72
|
| Rate for Payer: BCBS Trust/PPO |
$100.23
|
| Rate for Payer: BCN Commercial |
$94.90
|
| Rate for Payer: BCN Medicare Advantage |
$13.72
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.72
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Healthscope Whirlpool |
$118.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.72
|
| Rate for Payer: Mclaren Commercial |
$110.16
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| 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 |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.04
|
| Rate for Payer: Nomi Health Commercial |
$100.37
|
| 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 |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.25
|
| Rate for Payer: Priority Health Medicare |
$13.72
|
| Rate for Payer: Priority Health Narrow Network |
$85.80
|
| Rate for Payer: Railroad Medicare Medicare |
$13.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.72
|
| Rate for Payer: UHC Exchange |
$21.27
|
| Rate for Payer: UHC Medicare Advantage |
$13.72
|
| Rate for Payer: UHCCP DNSP |
$13.72
|
| Rate for Payer: UHCCP Medicaid |
$7.35
|
| Rate for Payer: VA VA |
$13.72
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$89.76 |
| Rate for Payer: Aetna Commercial |
$80.78
|
| Rate for Payer: ASR ASR |
$87.07
|
| Rate for Payer: ASR Commercial |
$87.07
|
| Rate for Payer: BCBS Trust/PPO |
$73.15
|
| Rate for Payer: BCN Commercial |
$69.59
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$84.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$89.76
|
| Rate for Payer: Healthscope Whirlpool |
$87.07
|
| Rate for Payer: Mclaren Commercial |
$80.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.99
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$89.76 |
| Rate for Payer: Aetna Commercial |
$80.78
|
| 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 |
$87.07
|
| Rate for Payer: ASR Commercial |
$87.07
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$73.50
|
| Rate for Payer: BCN Commercial |
$69.59
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$84.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$89.76
|
| Rate for Payer: Healthscope Whirlpool |
$87.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$80.78
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| 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 |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| 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 |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$24.02
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| 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 |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Complete |
$12.61
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$41.75
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.41
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$12.01
|
| 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 |
$12.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| 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 |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.67
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$35.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.41
|
| Rate for Payer: UHC Exchange |
$34.74
|
| Rate for Payer: UHC Medicare Advantage |
$22.41
|
| Rate for Payer: UHCCP DNSP |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$12.01
|
| Rate for Payer: VA VA |
$22.41
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| 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 |
$46.50
|
| Rate for Payer: ASR Commercial |
$46.50
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| 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 |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| 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 |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.01
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$33.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$24.02
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| Rate for Payer: ASR ASR |
$46.50
|
| Rate for Payer: ASR Commercial |
$46.50
|
| Rate for Payer: BCBS Trust/PPO |
$39.07
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
|
|
HC VMA URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| 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 |
$46.50
|
| Rate for Payer: ASR Commercial |
$46.50
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| 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 |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| 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 |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.01
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$33.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$24.02
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| Rate for Payer: ASR ASR |
$46.50
|
| Rate for Payer: ASR Commercial |
$46.50
|
| Rate for Payer: BCBS Trust/PPO |
$39.07
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$5,127.14
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$5,127.14 |
| Rate for Payer: Aetna Commercial |
$4,614.43
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,973.33
|
| Rate for Payer: ASR Commercial |
$4,973.33
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$4,198.61
|
| Rate for Payer: BCN Commercial |
$3,975.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cofinity Commercial |
$4,819.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,101.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$5,127.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,973.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,614.43
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.07
|
| Rate for Payer: Nomi Health Commercial |
$4,204.25
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,332.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,492.40
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,594.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,511.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$5,127.14
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,332.64 |
| Max. Negotiated Rate |
$5,127.14 |
| Rate for Payer: Aetna Commercial |
$4,614.43
|
| Rate for Payer: ASR ASR |
$4,973.33
|
| Rate for Payer: ASR Commercial |
$4,973.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,178.11
|
| Rate for Payer: BCN Commercial |
$3,975.07
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cofinity Commercial |
$4,819.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,101.71
|
| Rate for Payer: Healthscope Commercial |
$5,127.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,973.33
|
| Rate for Payer: Mclaren Commercial |
$4,614.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.07
|
| Rate for Payer: Nomi Health Commercial |
$4,204.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,332.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,511.88
|
|
