|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$92.82 |
| Rate for Payer: Aetna Commercial |
$83.54
|
| Rate for Payer: ASR ASR |
$90.04
|
| Rate for Payer: BCBS Trust/PPO |
$71.96
|
| Rate for Payer: BCN Commercial |
$71.96
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$87.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Healthscope Commercial |
$92.82
|
| Rate for Payer: Healthscope Whirlpool |
$90.04
|
| Rate for Payer: Mclaren Commercial |
$83.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.68
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$79.87
|
| Rate for Payer: BCN Commercial |
$79.87
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$103.02
|
| Rate for Payer: Healthscope Whirlpool |
$99.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$73.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.11 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$79.87
|
| Rate for Payer: BCN Commercial |
$79.87
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$103.02
|
| Rate for Payer: Healthscope Whirlpool |
$99.93
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$92.82 |
| Rate for Payer: Aetna Commercial |
$83.54
|
| Rate for Payer: ASR ASR |
$90.04
|
| Rate for Payer: BCBS Trust/PPO |
$71.96
|
| Rate for Payer: BCN Commercial |
$71.96
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$87.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Healthscope Commercial |
$92.82
|
| Rate for Payer: Healthscope Whirlpool |
$90.04
|
| Rate for Payer: Mclaren Commercial |
$83.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.68
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$92.82 |
| Rate for Payer: Aetna Commercial |
$83.54
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$90.04
|
| Rate for Payer: BCBS Complete |
$29.40
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$71.96
|
| Rate for Payer: BCN Commercial |
$71.96
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$87.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$92.82
|
| Rate for Payer: Healthscope Whirlpool |
$90.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$83.54
|
| Rate for Payer: Mclaren Medicaid |
$28.00
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Medicaid |
$29.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$28.00
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.47
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$65.90
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.68
|
| Rate for Payer: UHC Medicare Advantage |
$52.73
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC BCR / ABL FISH
|
Facility
|
OP
|
$128.52
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$128.52 |
| Rate for Payer: Aetna Commercial |
$115.67
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$124.66
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$99.64
|
| Rate for Payer: BCN Commercial |
$99.64
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$102.82
|
| Rate for Payer: Cash Price |
$102.82
|
| Rate for Payer: Cofinity Commercial |
$120.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$128.52
|
| Rate for Payer: Healthscope Whirlpool |
$124.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$115.67
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.24
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.95
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$91.25
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.10
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR / ABL FISH
|
Facility
|
IP
|
$128.52
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.96 |
| Max. Negotiated Rate |
$128.52 |
| Rate for Payer: Aetna Commercial |
$115.67
|
| Rate for Payer: ASR ASR |
$124.66
|
| Rate for Payer: BCBS Trust/PPO |
$99.64
|
| Rate for Payer: BCN Commercial |
$99.64
|
| Rate for Payer: Cash Price |
$102.82
|
| Rate for Payer: Cofinity Commercial |
$120.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.82
|
| Rate for Payer: Healthscope Commercial |
$128.52
|
| Rate for Payer: Healthscope Whirlpool |
$124.66
|
| Rate for Payer: Mclaren Commercial |
$115.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.10
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$79.87
|
| Rate for Payer: BCN Commercial |
$79.87
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$103.02
|
| Rate for Payer: Healthscope Whirlpool |
$99.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$73.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.11 |
| Max. Negotiated Rate |
$103.02 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: ASR ASR |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$79.87
|
| Rate for Payer: BCN Commercial |
$79.87
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$96.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$103.02
|
| Rate for Payer: Healthscope Whirlpool |
$99.93
|
| Rate for Payer: Mclaren Commercial |
$92.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.66
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$76.34
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$53.44 |
| Max. Negotiated Rate |
$76.34 |
| Rate for Payer: Aetna Commercial |
$68.71
|
| Rate for Payer: ASR ASR |
$74.05
|
| Rate for Payer: BCBS Trust/PPO |
$59.19
|
| Rate for Payer: BCN Commercial |
$59.19
|
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Cofinity Commercial |
$71.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.07
|
| Rate for Payer: Healthscope Commercial |
$76.34
|
| Rate for Payer: Healthscope Whirlpool |
$74.05
|
| Rate for Payer: Mclaren Commercial |
$68.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.18
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$76.34
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$76.34 |
| Rate for Payer: Aetna Commercial |
$68.71
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$74.05
|
| Rate for Payer: BCBS Complete |
$29.40
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.19
|
| Rate for Payer: BCN Commercial |
$59.19
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Cofinity Commercial |
$71.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$76.34
|
| Rate for Payer: Healthscope Whirlpool |
$74.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$68.71
|
| Rate for Payer: Mclaren Medicaid |
$28.00
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Medicaid |
$29.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.89
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$28.00
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.47
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$54.20
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.18
|
| Rate for Payer: UHC Medicare Advantage |
$52.73
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$382.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$267.75 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: ASR ASR |
$371.02
|
| Rate for Payer: BCBS Trust/PPO |
$296.55
|
| Rate for Payer: BCN Commercial |
$296.55
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$359.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$382.50
|
| Rate for Payer: Healthscope Whirlpool |
$371.02
|
| Rate for Payer: Mclaren Commercial |
$344.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.60
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$382.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$76.96 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: Aetna Medicare |
$163.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: ASR ASR |
$371.02
|
| Rate for Payer: BCBS Complete |
$94.18
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$296.55
|
| Rate for Payer: BCN Commercial |
$296.55
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$359.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$382.50
|
| Rate for Payer: Healthscope Whirlpool |
$371.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.96
|
| Rate for Payer: Mclaren Commercial |
$344.25
|
| Rate for Payer: Mclaren Medicaid |
$89.69
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Medicaid |
$94.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.12
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$180.36
|
| Rate for Payer: PHP Medicaid |
$89.69
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.20
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health Narrow Network |
$76.96
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.60
|
| Rate for Payer: UHC Medicare Advantage |
$168.88
|
| Rate for Payer: VA VA |
$163.96
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$222.36
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$155.65 |
| Max. Negotiated Rate |
$222.36 |
| Rate for Payer: Aetna Commercial |
$200.12
|
| Rate for Payer: ASR ASR |
$215.69
|
| Rate for Payer: BCBS Trust/PPO |
$172.40
|
| Rate for Payer: BCN Commercial |
$172.40
|
| Rate for Payer: Cash Price |
$177.89
|
| Rate for Payer: Cofinity Commercial |
$209.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.89
|
| Rate for Payer: Healthscope Commercial |
$222.36
|
| Rate for Payer: Healthscope Whirlpool |
$215.69
|
| Rate for Payer: Mclaren Commercial |
$200.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$189.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.68
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$222.36
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$222.36 |
| Rate for Payer: Aetna Commercial |
$200.12
|
| Rate for Payer: Aetna Medicare |
$144.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.05
|
| Rate for Payer: ASR ASR |
$215.69
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$144.84
|
| Rate for Payer: BCBS Trust/PPO |
$172.40
|
| Rate for Payer: BCN Commercial |
$172.40
|
| Rate for Payer: BCN Medicare Advantage |
$144.84
|
| Rate for Payer: Cash Price |
$177.89
|
| Rate for Payer: Cash Price |
$177.89
|
| Rate for Payer: Cofinity Commercial |
$209.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.84
|
| Rate for Payer: Healthscope Commercial |
$222.36
|
| Rate for Payer: Healthscope Whirlpool |
$215.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$144.84
|
| Rate for Payer: Mclaren Commercial |
$200.12
|
| Rate for Payer: Mclaren Medicaid |
$79.23
|
| Rate for Payer: Mclaren Medicare |
$144.84
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$189.01
|
| Rate for Payer: PACE Medicare |
$137.60
|
| Rate for Payer: PACE SWMI |
$144.84
|
| Rate for Payer: PHP Commercial |
$159.32
|
| Rate for Payer: PHP Medicaid |
$79.23
|
| Rate for Payer: PHP Medicare Advantage |
$144.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.09
|
| Rate for Payer: Priority Health Medicare |
$144.84
|
| Rate for Payer: Priority Health Narrow Network |
$68.07
|
| Rate for Payer: Railroad Medicare Medicare |
$144.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.68
|
| Rate for Payer: UHC Medicare Advantage |
$149.19
|
| Rate for Payer: VA VA |
$144.84
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$329.49
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$61.21 |
| Max. Negotiated Rate |
$329.49 |
| Rate for Payer: Aetna Commercial |
$296.54
|
| Rate for Payer: Aetna Medicare |
$214.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.28
|
| Rate for Payer: ASR ASR |
$319.61
|
| Rate for Payer: BCBS Complete |
$123.28
|
| Rate for Payer: BCBS MAPPO |
$214.62
|
| Rate for Payer: BCBS Trust/PPO |
$255.45
|
| Rate for Payer: BCN Commercial |
$255.45
|
| Rate for Payer: BCN Medicare Advantage |
$214.62
|
| Rate for Payer: Cash Price |
$263.59
|
| Rate for Payer: Cash Price |
$263.59
|
| Rate for Payer: Cofinity Commercial |
$309.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.62
|
| Rate for Payer: Healthscope Commercial |
$329.49
|
| Rate for Payer: Healthscope Whirlpool |
$319.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$214.62
|
| Rate for Payer: Mclaren Commercial |
$296.54
|
| Rate for Payer: Mclaren Medicaid |
$117.40
|
| Rate for Payer: Mclaren Medicare |
$214.62
|
| Rate for Payer: Meridian Medicaid |
$123.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$225.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.07
|
| Rate for Payer: PACE Medicare |
$203.89
|
| Rate for Payer: PACE SWMI |
$214.62
|
| Rate for Payer: PHP Commercial |
$236.08
|
| Rate for Payer: PHP Medicaid |
$117.40
|
| Rate for Payer: PHP Medicare Advantage |
$214.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.51
|
| Rate for Payer: Priority Health Medicare |
$214.62
|
| Rate for Payer: Priority Health Narrow Network |
$61.21
|
| Rate for Payer: Railroad Medicare Medicare |
$214.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.95
|
| Rate for Payer: UHC Medicare Advantage |
$221.06
|
| Rate for Payer: VA VA |
$214.62
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$329.49
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$230.64 |
| Max. Negotiated Rate |
$329.49 |
| Rate for Payer: Aetna Commercial |
$296.54
|
| Rate for Payer: ASR ASR |
$319.61
|
| Rate for Payer: BCBS Trust/PPO |
$255.45
|
| Rate for Payer: BCN Commercial |
$255.45
|
| Rate for Payer: Cash Price |
$263.59
|
| Rate for Payer: Cofinity Commercial |
$309.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.59
|
| Rate for Payer: Healthscope Commercial |
$329.49
|
| Rate for Payer: Healthscope Whirlpool |
$319.61
|
| Rate for Payer: Mclaren Commercial |
$296.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.95
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$256.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$76.96 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$230.85
|
| Rate for Payer: Aetna Medicare |
$163.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: ASR ASR |
$248.80
|
| Rate for Payer: BCBS Complete |
$94.18
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCBS Trust/PPO |
$198.86
|
| Rate for Payer: BCN Commercial |
$198.86
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cofinity Commercial |
$241.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Healthscope Whirlpool |
$248.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.96
|
| Rate for Payer: Mclaren Commercial |
$230.85
|
| Rate for Payer: Mclaren Medicaid |
$89.69
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Medicaid |
$94.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.02
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$180.36
|
| Rate for Payer: PHP Medicaid |
$89.69
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.20
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health Narrow Network |
$76.96
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.72
|
| Rate for Payer: UHC Medicare Advantage |
$168.88
|
| Rate for Payer: VA VA |
$163.96
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$256.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$179.55 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$230.85
|
| Rate for Payer: ASR ASR |
$248.80
|
| Rate for Payer: BCBS Trust/PPO |
$198.86
|
| Rate for Payer: BCN Commercial |
$198.86
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cofinity Commercial |
$241.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.20
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Healthscope Whirlpool |
$248.80
|
| Rate for Payer: Mclaren Commercial |
$230.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.72
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.85 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$34.89 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$6.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Complete |
$3.45
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.01
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$3.29
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$3.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$6.61
|
| Rate for Payer: PHP Medicaid |
$3.29
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.19
|
| Rate for Payer: VA VA |
$6.01
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$39.53
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$39.53 |
| Rate for Payer: Aetna Commercial |
$35.58
|
| Rate for Payer: ASR ASR |
$38.34
|
| Rate for Payer: BCBS Trust/PPO |
$30.65
|
| Rate for Payer: BCN Commercial |
$30.65
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cofinity Commercial |
$37.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$39.53
|
| Rate for Payer: Healthscope Whirlpool |
$38.34
|
| Rate for Payer: Mclaren Commercial |
$35.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.79
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$39.53
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$39.53 |
| Rate for Payer: Aetna Commercial |
$35.58
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: ASR ASR |
$38.34
|
| Rate for Payer: BCBS Complete |
$5.85
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$30.65
|
| Rate for Payer: BCN Commercial |
$30.65
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cofinity Commercial |
$37.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$39.53
|
| Rate for Payer: Healthscope Whirlpool |
$38.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.18
|
| Rate for Payer: Mclaren Commercial |
$35.58
|
| Rate for Payer: Mclaren Medicaid |
$5.57
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Medicaid |
$5.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.60
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$11.20
|
| Rate for Payer: PHP Medicaid |
$5.57
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.97
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.79
|
| Rate for Payer: UHC Medicare Advantage |
$10.49
|
| Rate for Payer: VA VA |
$10.18
|
|
|
HC BDIAL F8A
|
Facility
|
IP
|
$65.64
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.95 |
| Max. Negotiated Rate |
$65.64 |
| Rate for Payer: Aetna Commercial |
$59.08
|
| Rate for Payer: ASR ASR |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$50.89
|
| Rate for Payer: BCN Commercial |
$50.89
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cofinity Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.51
|
| Rate for Payer: Healthscope Commercial |
$65.64
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$59.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.76
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$65.64
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$65.64 |
| Rate for Payer: Aetna Commercial |
$59.08
|
| Rate for Payer: Aetna Medicare |
$17.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: ASR ASR |
$63.67
|
| Rate for Payer: BCBS Complete |
$10.28
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$50.89
|
| Rate for Payer: BCN Commercial |
$50.89
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cofinity Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$65.64
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.90
|
| Rate for Payer: Mclaren Commercial |
$59.08
|
| Rate for Payer: Mclaren Medicaid |
$9.79
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Medicaid |
$10.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.79
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$19.69
|
| Rate for Payer: PHP Medicaid |
$9.79
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.73
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$46.60
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.76
|
| Rate for Payer: UHC Medicare Advantage |
$18.44
|
| Rate for Payer: VA VA |
$17.90
|
|
