|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$70.69
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.52 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$63.62
|
| Rate for Payer: Aetna Medicare |
$13.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: ASR ASR |
$68.57
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$54.81
|
| Rate for Payer: BCN Commercial |
$54.81
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$66.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Healthscope Whirlpool |
$68.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.74
|
| Rate for Payer: Mclaren Commercial |
$63.62
|
| Rate for Payer: Mclaren Medicaid |
$7.52
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$15.11
|
| Rate for Payer: PHP Medicaid |
$7.52
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.87
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health Narrow Network |
$27.10
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.21
|
| Rate for Payer: UHC Medicare Advantage |
$14.15
|
| Rate for Payer: VA VA |
$13.74
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$70.69
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.48 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$63.62
|
| Rate for Payer: ASR ASR |
$68.57
|
| Rate for Payer: BCBS Trust/PPO |
$54.81
|
| Rate for Payer: BCN Commercial |
$54.81
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$66.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Healthscope Whirlpool |
$68.57
|
| Rate for Payer: Mclaren Commercial |
$63.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.21
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$70.69
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.48 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$63.62
|
| Rate for Payer: ASR ASR |
$68.57
|
| Rate for Payer: BCBS Trust/PPO |
$54.81
|
| Rate for Payer: BCN Commercial |
$54.81
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$66.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Healthscope Whirlpool |
$68.57
|
| Rate for Payer: Mclaren Commercial |
$63.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.21
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$70.69
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$63.62
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$68.57
|
| Rate for Payer: BCBS Complete |
$6.94
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$54.81
|
| Rate for Payer: BCN Commercial |
$54.81
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$66.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Healthscope Whirlpool |
$68.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$63.62
|
| Rate for Payer: Mclaren Medicaid |
$6.61
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Medicaid |
$6.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.09
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.61
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.21
|
| Rate for Payer: UHC Medicare Advantage |
$12.45
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Complete |
$6.94
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$6.61
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Medicaid |
$6.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.61
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
| Rate for Payer: UHC Medicare Advantage |
$12.45
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$11.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.95
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Complete |
$6.41
|
| Rate for Payer: BCBS MAPPO |
$11.16
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: BCN Medicare Advantage |
$11.16
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.16
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$6.10
|
| Rate for Payer: Mclaren Medicare |
$11.16
|
| Rate for Payer: Meridian Medicaid |
$6.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$10.60
|
| Rate for Payer: PACE SWMI |
$11.16
|
| Rate for Payer: PHP Commercial |
$12.28
|
| Rate for Payer: PHP Medicaid |
$6.10
|
| Rate for Payer: PHP Medicare Advantage |
$11.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.84
|
| Rate for Payer: Priority Health Medicare |
$11.16
|
| Rate for Payer: Priority Health Narrow Network |
$26.27
|
| Rate for Payer: Railroad Medicare Medicare |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
| Rate for Payer: UHC Medicare Advantage |
$11.49
|
| Rate for Payer: VA VA |
$11.16
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$48.96
|
| 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: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$43.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| 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
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: ASR ASR |
$65.96
|
| Rate for Payer: BCBS Trust/PPO |
$52.72
|
| Rate for Payer: BCN Commercial |
$52.72
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$63.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Healthscope Commercial |
$68.00
|
| Rate for Payer: Healthscope Whirlpool |
$65.96
|
| Rate for Payer: Mclaren Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.84
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna Medicare |
$7.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.12
|
| Rate for Payer: ASR ASR |
$65.96
|
| Rate for Payer: BCBS Complete |
$4.19
|
| Rate for Payer: BCBS MAPPO |
$7.30
|
| Rate for Payer: BCBS Trust/PPO |
$52.72
|
| Rate for Payer: BCN Commercial |
$52.72
|
| Rate for Payer: BCN Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$63.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.30
|
| Rate for Payer: Healthscope Commercial |
$68.00
|
| Rate for Payer: Healthscope Whirlpool |
$65.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.30
|
| Rate for Payer: Mclaren Commercial |
$61.20
|
| Rate for Payer: Mclaren Medicaid |
$3.99
|
| Rate for Payer: Mclaren Medicare |
$7.30
|
| Rate for Payer: Meridian Medicaid |
$4.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE SWMI |
$7.30
|
| Rate for Payer: PHP Commercial |
$8.03
|
| Rate for Payer: PHP Medicaid |
$3.99
|
| Rate for Payer: PHP Medicare Advantage |
$7.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.73
|
| Rate for Payer: Priority Health Medicare |
$7.30
|
| Rate for Payer: Priority Health Narrow Network |
$22.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.84
|
| Rate for Payer: UHC Medicare Advantage |
$7.52
|
| Rate for Payer: VA VA |
$7.30
|
|
|
HC ANTI THROMBIN III
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: BCBS Trust/PPO |
$37.96
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$133.41 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$11.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.81
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: BCBS Complete |
$6.81
|
| Rate for Payer: BCBS MAPPO |
$11.85
|
| Rate for Payer: BCBS Trust/PPO |
$37.96
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: BCN Medicare Advantage |
$11.85
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.85
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.85
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$11.85
|
| Rate for Payer: Meridian Medicaid |
$6.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Medicare |
$11.26
|
| Rate for Payer: PACE SWMI |
$11.85
|
| Rate for Payer: PHP Commercial |
$13.04
|
| Rate for Payer: PHP Medicaid |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.41
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health Narrow Network |
$106.73
|
| Rate for Payer: Railroad Medicare Medicare |
$11.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Medicare Advantage |
$12.21
|
| Rate for Payer: VA VA |
$11.85
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: ASR ASR |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$46.52
|
| Rate for Payer: BCN Commercial |
$46.52
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$60.00
|
| Rate for Payer: Healthscope Whirlpool |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.80
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: Aetna Medicare |
$10.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.51
|
| Rate for Payer: ASR ASR |
$58.20
|
| Rate for Payer: BCBS Complete |
$6.21
|
| Rate for Payer: BCBS MAPPO |
$10.81
|
| Rate for Payer: BCBS Trust/PPO |
$46.52
|
| Rate for Payer: BCN Commercial |
$46.52
|
| Rate for Payer: BCN Medicare Advantage |
$10.81
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$60.00
|
| Rate for Payer: Healthscope Whirlpool |
$58.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.81
|
| Rate for Payer: Mclaren Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$5.91
|
| Rate for Payer: Mclaren Medicare |
$10.81
|
| Rate for Payer: Meridian Medicaid |
$6.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Medicare |
$10.27
|
| Rate for Payer: PACE SWMI |
$10.81
|
| Rate for Payer: PHP Commercial |
$11.89
|
| Rate for Payer: PHP Medicaid |
$5.91
|
| Rate for Payer: PHP Medicare Advantage |
$10.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$10.81
|
| Rate for Payer: Priority Health Narrow Network |
$42.60
|
| Rate for Payer: Railroad Medicare Medicare |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.80
|
| Rate for Payer: UHC Medicare Advantage |
$11.13
|
| Rate for Payer: VA VA |
$10.81
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.88 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Medicare |
$43.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.56
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Complete |
$25.07
|
| Rate for Payer: BCBS MAPPO |
$43.65
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: BCN Medicare Advantage |
$43.65
|
| Rate for Payer: Cash Price |
$48.96
|
| 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: Health Alliance Plan Medicare Advantage |
$43.65
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$43.65
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$23.88
|
| Rate for Payer: Mclaren Medicare |
$43.65
|
| Rate for Payer: Meridian Medicaid |
$25.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$41.47
|
| Rate for Payer: PACE SWMI |
$43.65
|
| Rate for Payer: PHP Commercial |
$48.02
|
| Rate for Payer: PHP Medicaid |
$23.88
|
| Rate for Payer: PHP Medicare Advantage |
$43.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.33
|
| Rate for Payer: Priority Health Medicare |
$43.65
|
| Rate for Payer: Priority Health Narrow Network |
$52.26
|
| Rate for Payer: Railroad Medicare Medicare |
$43.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
| Rate for Payer: UHC Medicare Advantage |
$44.96
|
| Rate for Payer: VA VA |
$43.65
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| 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
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
OP
|
$717.35
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$286.94 |
| Max. Negotiated Rate |
$717.35 |
| Rate for Payer: Aetna Commercial |
$645.62
|
| Rate for Payer: ASR ASR |
$695.83
|
| Rate for Payer: BCBS Complete |
$286.94
|
| Rate for Payer: BCBS Trust/PPO |
$556.16
|
| Rate for Payer: BCN Commercial |
$556.16
|
| Rate for Payer: Cash Price |
$573.88
|
| Rate for Payer: Cofinity Commercial |
$674.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$573.88
|
| Rate for Payer: Healthscope Commercial |
$717.35
|
| Rate for Payer: Healthscope Whirlpool |
$695.83
|
| Rate for Payer: Mclaren Commercial |
$645.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$609.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.79
|
| Rate for Payer: Priority Health Narrow Network |
$509.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$631.27
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
IP
|
$717.35
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$502.14 |
| Max. Negotiated Rate |
$717.35 |
| Rate for Payer: Aetna Commercial |
$645.62
|
| Rate for Payer: ASR ASR |
$695.83
|
| Rate for Payer: BCBS Trust/PPO |
$556.16
|
| Rate for Payer: BCN Commercial |
$556.16
|
| Rate for Payer: Cash Price |
$573.88
|
| Rate for Payer: Cofinity Commercial |
$674.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$573.88
|
| Rate for Payer: Healthscope Commercial |
$717.35
|
| Rate for Payer: Healthscope Whirlpool |
$695.83
|
| Rate for Payer: Mclaren Commercial |
$645.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$609.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$631.27
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,294.92
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$906.44 |
| Max. Negotiated Rate |
$1,294.92 |
| Rate for Payer: Aetna Commercial |
$1,165.43
|
| Rate for Payer: ASR ASR |
$1,256.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.95
|
| Rate for Payer: BCN Commercial |
$1,003.95
|
| Rate for Payer: Cash Price |
$1,035.94
|
| Rate for Payer: Cofinity Commercial |
$1,217.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.94
|
| Rate for Payer: Healthscope Commercial |
$1,294.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,256.07
|
| Rate for Payer: Mclaren Commercial |
$1,165.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,100.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,139.53
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
OP
|
$1,294.92
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,294.92 |
| Rate for Payer: Aetna Commercial |
$1,165.43
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$1,256.07
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.95
|
| Rate for Payer: BCN Commercial |
$1,003.95
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,035.94
|
| Rate for Payer: Cash Price |
$1,035.94
|
| Rate for Payer: Cofinity Commercial |
$1,217.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,294.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,256.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,165.43
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,100.68
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.38
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$919.39
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,139.53
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$560.37 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$728.48
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$568.38
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC APHERESIS
|
Facility
|
OP
|
$2,505.38
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,002.15 |
| Max. Negotiated Rate |
$2,505.38 |
| Rate for Payer: Aetna Commercial |
$2,254.84
|
| Rate for Payer: ASR ASR |
$2,430.22
|
| Rate for Payer: BCBS Complete |
$1,002.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.42
|
| Rate for Payer: BCN Commercial |
$1,942.42
|
| Rate for Payer: Cash Price |
$2,004.30
|
| Rate for Payer: Cofinity Commercial |
$2,355.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.30
|
| Rate for Payer: Healthscope Commercial |
$2,505.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,430.22
|
| Rate for Payer: Mclaren Commercial |
$2,254.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,129.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,753.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,279.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,778.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,204.73
|
|
