|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,035.52
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,153.84 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$2,731.97
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$2,944.45
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,353.44
|
| Rate for Payer: BCN Commercial |
$2,353.44
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,853.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,035.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,944.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$2,731.97
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,442.30
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,671.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,035.52
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,124.86 |
| Max. Negotiated Rate |
$3,035.52 |
| Rate for Payer: Aetna Commercial |
$2,731.97
|
| Rate for Payer: ASR ASR |
$2,944.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,353.44
|
| Rate for Payer: BCN Commercial |
$2,353.44
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,853.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Healthscope Commercial |
$3,035.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,944.45
|
| Rate for Payer: Mclaren Commercial |
$2,731.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,671.26
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,035.52
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$422.78 |
| Max. Negotiated Rate |
$3,035.52 |
| Rate for Payer: Aetna Commercial |
$2,731.97
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$2,944.45
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,353.44
|
| Rate for Payer: BCN Commercial |
$2,353.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,853.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$3,035.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,944.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$2,731.97
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$528.48
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$422.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,671.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$17.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.40
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$17.12
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$17.12
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$9.36
|
| Rate for Payer: Mclaren Medicare |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$16.26
|
| Rate for Payer: PACE SWMI |
$17.12
|
| Rate for Payer: PHP Commercial |
$18.83
|
| Rate for Payer: PHP Medicaid |
$9.36
|
| Rate for Payer: PHP Medicare Advantage |
$17.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$17.12
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$17.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$17.63
|
| Rate for Payer: VA VA |
$17.12
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$26.53 |
| Max. Negotiated Rate |
$37.90 |
| Rate for Payer: Aetna Commercial |
$34.11
|
| Rate for Payer: ASR ASR |
$36.76
|
| Rate for Payer: BCBS Trust/PPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$35.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$37.90
|
| Rate for Payer: Healthscope Whirlpool |
$36.76
|
| Rate for Payer: Mclaren Commercial |
$34.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.35
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$37.90 |
| Rate for Payer: Aetna Commercial |
$34.11
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: ASR ASR |
$36.76
|
| Rate for Payer: BCBS Complete |
$1.25
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$35.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$37.90
|
| Rate for Payer: Healthscope Whirlpool |
$36.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.17
|
| Rate for Payer: Mclaren Commercial |
$34.11
|
| Rate for Payer: Mclaren Medicaid |
$1.19
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Medicaid |
$1.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$2.39
|
| Rate for Payer: PHP Medicaid |
$1.19
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$26.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.35
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$3,988.27
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,791.79 |
| Max. Negotiated Rate |
$8,406.09 |
| Rate for Payer: Aetna Commercial |
$3,589.44
|
| Rate for Payer: Aetna Medicare |
$6,724.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,406.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,406.09
|
| Rate for Payer: ASR ASR |
$3,868.62
|
| Rate for Payer: BCBS Complete |
$3,862.77
|
| Rate for Payer: BCBS MAPPO |
$6,724.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,092.11
|
| Rate for Payer: BCN Commercial |
$3,092.11
|
| Rate for Payer: BCN Medicare Advantage |
$6,724.87
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cofinity Commercial |
$3,748.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,724.87
|
| Rate for Payer: Healthscope Commercial |
$3,988.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,868.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,724.87
|
| Rate for Payer: Mclaren Commercial |
$3,589.44
|
| Rate for Payer: Mclaren Medicaid |
$3,678.50
|
| Rate for Payer: Mclaren Medicare |
$6,724.87
|
| Rate for Payer: Meridian Medicaid |
$3,862.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,061.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,733.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,390.03
|
| Rate for Payer: PACE Medicare |
$6,388.63
|
| Rate for Payer: PACE SWMI |
$6,724.87
|
| Rate for Payer: PHP Commercial |
$7,397.36
|
| Rate for Payer: PHP Medicaid |
$3,678.50
|
| Rate for Payer: PHP Medicare Advantage |
$6,724.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,678.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,791.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,629.33
|
| Rate for Payer: Priority Health Medicare |
$6,724.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,831.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6,724.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,509.68
|
| Rate for Payer: UHC Medicare Advantage |
$6,926.62
|
| Rate for Payer: VA VA |
$6,724.87
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$3,988.27
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,791.79 |
| Max. Negotiated Rate |
$3,988.27 |
| Rate for Payer: Aetna Commercial |
$3,589.44
|
| Rate for Payer: ASR ASR |
$3,868.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,092.11
|
| Rate for Payer: BCN Commercial |
$3,092.11
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cofinity Commercial |
$3,748.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.62
|
| Rate for Payer: Healthscope Commercial |
$3,988.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,868.62
|
| Rate for Payer: Mclaren Commercial |
$3,589.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,390.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,791.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,509.68
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$459.89
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$321.92 |
| Max. Negotiated Rate |
$459.89 |
| Rate for Payer: Aetna Commercial |
$413.90
|
| Rate for Payer: ASR ASR |
$446.09
|
| Rate for Payer: BCBS Trust/PPO |
$356.55
|
| Rate for Payer: BCN Commercial |
$356.55
|
| Rate for Payer: Cash Price |
$367.91
|
| Rate for Payer: Cofinity Commercial |
$432.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.91
|
| Rate for Payer: Healthscope Commercial |
$459.89
|
| Rate for Payer: Healthscope Whirlpool |
$446.09
|
| Rate for Payer: Mclaren Commercial |
$413.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.70
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$459.89
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$183.96 |
| Max. Negotiated Rate |
$459.89 |
| Rate for Payer: Aetna Commercial |
$413.90
|
| Rate for Payer: ASR ASR |
$446.09
|
| Rate for Payer: BCBS Complete |
$183.96
|
| Rate for Payer: BCBS Trust/PPO |
$356.55
|
| Rate for Payer: BCN Commercial |
$356.55
|
| Rate for Payer: Cash Price |
$367.91
|
| Rate for Payer: Cofinity Commercial |
$432.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.91
|
| Rate for Payer: Healthscope Commercial |
$459.89
|
| Rate for Payer: Healthscope Whirlpool |
$446.09
|
| Rate for Payer: Mclaren Commercial |
$413.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.50
|
| Rate for Payer: Priority Health Narrow Network |
$326.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.70
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,819.24
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$727.70 |
| Max. Negotiated Rate |
$1,819.24 |
| Rate for Payer: Aetna Commercial |
$1,637.32
|
| Rate for Payer: ASR ASR |
$1,764.66
|
| Rate for Payer: BCBS Complete |
$727.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.46
|
| Rate for Payer: BCN Commercial |
$1,410.46
|
| Rate for Payer: Cash Price |
$1,455.39
|
| Rate for Payer: Cofinity Commercial |
$1,710.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.39
|
| Rate for Payer: Healthscope Commercial |
$1,819.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,764.66
|
| Rate for Payer: Mclaren Commercial |
$1,637.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,600.93
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,819.24
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,273.47 |
| Max. Negotiated Rate |
$1,819.24 |
| Rate for Payer: Aetna Commercial |
$1,637.32
|
| Rate for Payer: ASR ASR |
$1,764.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.46
|
| Rate for Payer: BCN Commercial |
$1,410.46
|
| Rate for Payer: Cash Price |
$1,455.39
|
| Rate for Payer: Cofinity Commercial |
$1,710.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.39
|
| Rate for Payer: Healthscope Commercial |
$1,819.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,764.66
|
| Rate for Payer: Mclaren Commercial |
$1,637.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,600.93
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$2.75
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$5.52
|
| Rate for Payer: PHP Medicaid |
$2.75
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$11.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$5.17
|
| Rate for Payer: VA VA |
$5.02
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$26.69 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$2.75
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$5.52
|
| Rate for Payer: PHP Medicaid |
$2.75
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.69
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$21.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$5.17
|
| Rate for Payer: VA VA |
$5.02
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
OP
|
$46.55
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$46.55 |
| Rate for Payer: Aetna Commercial |
$41.90
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: ASR ASR |
$45.15
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$36.09
|
| Rate for Payer: BCN Commercial |
$36.09
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$37.24
|
| Rate for Payer: Cash Price |
$37.24
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$46.55
|
| Rate for Payer: Healthscope Whirlpool |
$45.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$41.90
|
| Rate for Payer: Mclaren Medicaid |
$2.75
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.57
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$5.52
|
| Rate for Payer: PHP Medicaid |
$2.75
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.44
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$13.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.96
|
| Rate for Payer: UHC Medicare Advantage |
$5.17
|
| Rate for Payer: VA VA |
$5.02
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
IP
|
$46.55
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$46.55 |
| Rate for Payer: Aetna Commercial |
$41.90
|
| Rate for Payer: ASR ASR |
$45.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.09
|
| Rate for Payer: BCN Commercial |
$36.09
|
| Rate for Payer: Cash Price |
$37.24
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.24
|
| Rate for Payer: Healthscope Commercial |
$46.55
|
| Rate for Payer: Healthscope Whirlpool |
$45.15
|
| Rate for Payer: Mclaren Commercial |
$41.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.96
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
IP
|
$96.80
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.76 |
| Max. Negotiated Rate |
$96.80 |
| Rate for Payer: Aetna Commercial |
$87.12
|
| Rate for Payer: ASR ASR |
$93.90
|
| Rate for Payer: BCBS Trust/PPO |
$75.05
|
| Rate for Payer: BCN Commercial |
$75.05
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cofinity Commercial |
$90.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.44
|
| Rate for Payer: Healthscope Commercial |
$96.80
|
| Rate for Payer: Healthscope Whirlpool |
$93.90
|
| Rate for Payer: Mclaren Commercial |
$87.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.18
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
OP
|
$96.80
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$96.80 |
| Rate for Payer: Aetna Commercial |
$87.12
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$93.90
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$75.05
|
| Rate for Payer: BCN Commercial |
$75.05
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cofinity Commercial |
$90.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$96.80
|
| Rate for Payer: Healthscope Whirlpool |
$93.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$87.12
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.28
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.09
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$68.73
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.18
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.89
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.84
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$31.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$12.98
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
IP
|
$99.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.96 |
| Max. Negotiated Rate |
$99.95 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: ASR ASR |
$96.95
|
| Rate for Payer: BCBS Trust/PPO |
$77.49
|
| Rate for Payer: BCN Commercial |
$77.49
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.96
|
| Rate for Payer: Healthscope Commercial |
$99.95
|
| Rate for Payer: Healthscope Whirlpool |
$96.95
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
OP
|
$99.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$99.95 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$96.95
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.49
|
| Rate for Payer: BCN Commercial |
$77.49
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$99.95
|
| Rate for Payer: Healthscope Whirlpool |
$96.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.96
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.95
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$70.96
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
