|
HC ALLERGY SCREEN INDOOR 1 ALLERG
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC ALLERGY SCREEN INDOOR 1 ALLERG
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALLERGY SCREEN MOLDS
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC ALLERGY SCREEN MOLDS
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Aetna Commercial |
$20.20
|
| Rate for Payer: ASR ASR |
$21.77
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$21.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$22.44
|
| Rate for Payer: Healthscope Whirlpool |
$21.77
|
| Rate for Payer: Mclaren Commercial |
$20.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.75
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Aetna Commercial |
$20.20
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.29
|
| Rate for Payer: ASR ASR |
$21.77
|
| Rate for Payer: BCBS Complete |
$3.35
|
| Rate for Payer: BCBS MAPPO |
$5.83
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$5.83
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$21.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.83
|
| Rate for Payer: Healthscope Commercial |
$22.44
|
| Rate for Payer: Healthscope Whirlpool |
$21.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.83
|
| Rate for Payer: Mclaren Commercial |
$20.20
|
| Rate for Payer: Mclaren Medicaid |
$3.19
|
| Rate for Payer: Mclaren Medicare |
$5.83
|
| Rate for Payer: Meridian Medicaid |
$3.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Medicare |
$5.54
|
| Rate for Payer: PACE SWMI |
$5.83
|
| Rate for Payer: PHP Commercial |
$6.41
|
| Rate for Payer: PHP Medicaid |
$3.19
|
| Rate for Payer: PHP Medicare Advantage |
$5.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.42
|
| Rate for Payer: Priority Health Medicare |
$5.83
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$6.00
|
| Rate for Payer: VA VA |
$5.83
|
|
|
HC ALMONDS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC ALMONDS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
IP
|
$48.44
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$33.91 |
| Max. Negotiated Rate |
$48.44 |
| Rate for Payer: Aetna Commercial |
$43.60
|
| Rate for Payer: ASR ASR |
$46.99
|
| Rate for Payer: BCBS Trust/PPO |
$37.56
|
| Rate for Payer: BCN Commercial |
$37.56
|
| Rate for Payer: Cash Price |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$45.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$48.44
|
| Rate for Payer: Healthscope Whirlpool |
$46.99
|
| Rate for Payer: Mclaren Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.63
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
OP
|
$48.44
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$48.44 |
| Rate for Payer: Aetna Commercial |
$43.60
|
| Rate for Payer: ASR ASR |
$46.99
|
| Rate for Payer: BCBS Complete |
$19.38
|
| Rate for Payer: BCBS Trust/PPO |
$37.56
|
| Rate for Payer: BCN Commercial |
$37.56
|
| Rate for Payer: Cash Price |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$45.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$48.44
|
| Rate for Payer: Healthscope Whirlpool |
$46.99
|
| Rate for Payer: Mclaren Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.08
|
| Rate for Payer: Priority Health Narrow Network |
$34.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.63
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
OP
|
$16.45
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$16.45 |
| Rate for Payer: Aetna Commercial |
$14.80
|
| Rate for Payer: ASR ASR |
$15.96
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS Trust/PPO |
$12.75
|
| Rate for Payer: BCN Commercial |
$12.75
|
| Rate for Payer: Cash Price |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.16
|
| Rate for Payer: Healthscope Commercial |
$16.45
|
| Rate for Payer: Healthscope Whirlpool |
$15.96
|
| Rate for Payer: Mclaren Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.97
|
| Rate for Payer: Priority Health Narrow Network |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.48
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
IP
|
$16.45
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.52 |
| Max. Negotiated Rate |
$16.45 |
| Rate for Payer: Aetna Commercial |
$14.80
|
| Rate for Payer: ASR ASR |
$15.96
|
| Rate for Payer: BCBS Trust/PPO |
$12.75
|
| Rate for Payer: BCN Commercial |
$12.75
|
| Rate for Payer: Cash Price |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.16
|
| Rate for Payer: Healthscope Commercial |
$16.45
|
| Rate for Payer: Healthscope Whirlpool |
$15.96
|
| Rate for Payer: Mclaren Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.48
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
OP
|
$41.48
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$41.48 |
| Rate for Payer: Aetna Commercial |
$37.33
|
| Rate for Payer: ASR ASR |
$40.24
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$32.16
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$38.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$41.48
|
| Rate for Payer: Healthscope Whirlpool |
$40.24
|
| Rate for Payer: Mclaren Commercial |
$37.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.75
|
| Rate for Payer: Priority Health Narrow Network |
$29.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.50
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
IP
|
$41.48
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$29.04 |
| Max. Negotiated Rate |
$41.48 |
| Rate for Payer: Aetna Commercial |
$37.33
|
| Rate for Payer: ASR ASR |
$40.24
|
| Rate for Payer: BCBS Trust/PPO |
$32.16
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$38.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$41.48
|
| Rate for Payer: Healthscope Whirlpool |
$40.24
|
| Rate for Payer: Mclaren Commercial |
$37.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.50
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$58.00 |
| Rate for Payer: Aetna Commercial |
$52.20
|
| Rate for Payer: ASR ASR |
$56.26
|
| Rate for Payer: BCBS Trust/PPO |
$44.97
|
| Rate for Payer: BCN Commercial |
$44.97
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$54.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Healthscope Commercial |
$58.00
|
| Rate for Payer: Healthscope Whirlpool |
$56.26
|
| Rate for Payer: Mclaren Commercial |
$52.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.04
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$58.00 |
| Rate for Payer: Aetna Commercial |
$52.20
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.08
|
| Rate for Payer: ASR ASR |
$56.26
|
| Rate for Payer: BCBS Complete |
$8.31
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$44.97
|
| Rate for Payer: BCN Commercial |
$44.97
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$54.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$58.00
|
| Rate for Payer: Healthscope Whirlpool |
$56.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.46
|
| Rate for Payer: Mclaren Commercial |
$52.20
|
| Rate for Payer: Mclaren Medicaid |
$7.91
|
| Rate for Payer: Mclaren Medicare |
$14.46
|
| Rate for Payer: Meridian Medicaid |
$8.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PACE Medicare |
$13.74
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$15.91
|
| Rate for Payer: PHP Medicaid |
$7.91
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.78
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow Network |
$41.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.04
|
| Rate for Payer: UHC Medicare Advantage |
$14.89
|
| Rate for Payer: VA VA |
$14.46
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.99 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: BCBS Trust/PPO |
$33.21
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$33.21
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.80
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$87.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.99 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Trust/PPO |
$27.68
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$27.68
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.44
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$14.78
|
| Rate for Payer: PHP Medicaid |
$7.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.80
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$87.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
| Rate for Payer: VA VA |
$13.44
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
