|
CHG ASSAY OF ALCOHOL (ETHANOL) BREATH
|
Professional
|
$60.00
|
|
|
Service Code
|
CPT 82075
|
| Hospital Charge Code |
Z12977
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Coventry/First Health All Products |
$72.00
|
| Rate for Payer: Frontpath All Products |
$30.00
|
| Rate for Payer: Humana ChoiceCare |
$60.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$45.00
|
| Rate for Payer: PHP All Products |
$26.40
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$10.56
|
|
|
CHG ASSAY OF LEAD
|
Professional
|
$24.22
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Z12985
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$29.06 |
| Rate for Payer: Coventry/First Health All Products |
$29.06
|
| Rate for Payer: Frontpath All Products |
$12.11
|
| Rate for Payer: Humana ChoiceCare |
$24.22
|
| Rate for Payer: PHCS/Multiplan All Products |
$18.16
|
| Rate for Payer: PHP All Products |
$10.66
|
| Rate for Payer: United Healthcare Commercial |
$10.60
|
|
|
CHG BILIRUBIN TOTAL TRANSCUTANEOUS
|
Professional
|
$10.04
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
Z13009
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$12.05 |
| Rate for Payer: Anthem Exchange |
$2.82
|
| Rate for Payer: Anthem PPO |
$2.82
|
| Rate for Payer: Anthem Traditional |
$2.82
|
| Rate for Payer: Coventry/First Health All Products |
$12.05
|
| Rate for Payer: Frontpath All Products |
$5.02
|
| Rate for Payer: Humana ChoiceCare |
$10.04
|
| Rate for Payer: Lutheran Preferred All Products |
$7.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$7.53
|
| Rate for Payer: PHP All Products |
$4.42
|
| Rate for Payer: Signature Care EPO |
$8.53
|
| Rate for Payer: Signature Care PPO |
$8.53
|
| Rate for Payer: Three Rivers Preferred All Products |
$7.00
|
| Rate for Payer: United Healthcare Commercial |
$7.33
|
|
|
CHG BLOOD,OCCULT,FECAL HGB,FECES,1-3 SIMULT
|
Professional
|
$31.84
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
Z12979
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$38.21 |
| Rate for Payer: Coventry/First Health All Products |
$38.21
|
| Rate for Payer: Frontpath All Products |
$15.92
|
| Rate for Payer: Humana ChoiceCare |
$31.84
|
| Rate for Payer: Lutheran Preferred All Products |
$22.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$23.88
|
| Rate for Payer: PHP All Products |
$14.01
|
| Rate for Payer: Signature Care EPO |
$18.40
|
| Rate for Payer: Signature Care PPO |
$18.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$21.00
|
| Rate for Payer: United Healthcare Commercial |
$23.22
|
|
|
CHG BLOOD,OCCULT,FECAL HGB,FECES,1-3 SIMULT
|
Professional
|
$31.84
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
Z12978
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$38.21 |
| Rate for Payer: Coventry/First Health All Products |
$38.21
|
| Rate for Payer: Frontpath All Products |
$15.92
|
| Rate for Payer: Humana ChoiceCare |
$31.84
|
| Rate for Payer: Lutheran Preferred All Products |
$22.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$23.88
|
| Rate for Payer: PHP All Products |
$14.01
|
| Rate for Payer: Signature Care EPO |
$18.40
|
| Rate for Payer: Signature Care PPO |
$18.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$21.00
|
| Rate for Payer: United Healthcare Commercial |
$23.22
|
|
|
CHG CYTOPAT,CER/VAG,THIN LAYER,MAN RES,INTER
|
Professional
|
$53.22
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
Z13008
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$63.86 |
| Rate for Payer: Anthem Exchange |
$15.01
|
| Rate for Payer: Anthem PPO |
$15.01
|
| Rate for Payer: Anthem Traditional |
$15.01
|
| Rate for Payer: Coventry/First Health All Products |
$63.86
|
| Rate for Payer: Frontpath All Products |
$26.61
|
| Rate for Payer: Humana ChoiceCare |
$53.22
|
| Rate for Payer: Lutheran Preferred All Products |
$37.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$39.91
|
| Rate for Payer: PHP All Products |
$23.42
|
| Rate for Payer: Signature Care EPO |
$45.24
|
| Rate for Payer: Signature Care PPO |
$45.24
|
| Rate for Payer: Three Rivers Preferred All Products |
$35.00
|
| Rate for Payer: United Healthcare Commercial |
$37.49
|
|
|
CHG DETECT AGENT, MULT ORGS, DNA, AMP
|
Professional
|
$140.40
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
Z13001
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$168.48 |
| Rate for Payer: Anthem Exchange |
$33.20
|
| Rate for Payer: Anthem PPO |
$33.20
|
| Rate for Payer: Anthem Traditional |
$33.20
|
| Rate for Payer: Coventry/First Health All Products |
$168.48
|
| Rate for Payer: Frontpath All Products |
$70.20
|
| Rate for Payer: Humana ChoiceCare |
$140.40
|
| Rate for Payer: Lutheran Preferred All Products |
$98.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$105.30
|
| Rate for Payer: PHP All Products |
$61.78
|
| Rate for Payer: Signature Care EPO |
$91.80
|
| Rate for Payer: Signature Care PPO |
$91.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$91.00
|
| Rate for Payer: United Healthcare Commercial |
$61.49
|
|
|
CHG DOPPLER FETAL UMBILICAL ARTERY
|
Professional
|
$83.08
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
Z12955
|
| Min. Negotiated Rate |
$42.58 |
| Max. Negotiated Rate |
$99.70 |
| Rate for Payer: Aetna Medicare |
$42.58
|
| Rate for Payer: Anthem Exchange |
$79.86
|
| Rate for Payer: Anthem Medicare |
$42.58
|
| Rate for Payer: Anthem PPO |
$79.86
|
| Rate for Payer: Anthem Traditional |
$79.86
|
| Rate for Payer: Caresource Just 4 Me |
$48.97
|
| Rate for Payer: Caresource Medicare |
$46.84
|
| Rate for Payer: Centivo/Paragon All Products |
$66.00
|
| Rate for Payer: Coventry/First Health All Products |
$99.70
|
| Rate for Payer: Frontpath All Products |
$75.40
|
| Rate for Payer: Humana ChoiceCare |
$83.08
|
| Rate for Payer: Humana Medicare |
$42.58
|
| Rate for Payer: Lucent/Coldwater Veneers |
$72.39
|
| Rate for Payer: Lutheran Preferred All Products |
$66.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$62.31
|
| Rate for Payer: PHP All Products |
$54.00
|
| Rate for Payer: Plain Church Group Ministry All Products |
$42.58
|
| Rate for Payer: Signature Care EPO |
$73.66
|
| Rate for Payer: Signature Care PPO |
$73.66
|
| Rate for Payer: Three Rivers Preferred All Products |
$62.00
|
| Rate for Payer: United Healthcare Commercial |
$50.08
|
|
|
CHG DOPPLER FETAL UMBILICAL ARTERY
|
Professional
|
$83.08
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
Z12956
|
| Min. Negotiated Rate |
$42.58 |
| Max. Negotiated Rate |
$99.70 |
| Rate for Payer: Humana Medicare |
$42.58
|
| Rate for Payer: Aetna Medicare |
$42.58
|
| Rate for Payer: Anthem Exchange |
$79.86
|
| Rate for Payer: Anthem Medicare |
$42.58
|
| Rate for Payer: Anthem PPO |
$79.86
|
| Rate for Payer: Anthem Traditional |
$79.86
|
| Rate for Payer: Caresource Just 4 Me |
$48.97
|
| Rate for Payer: Caresource Medicare |
$46.84
|
| Rate for Payer: Centivo/Paragon All Products |
$66.00
|
| Rate for Payer: Coventry/First Health All Products |
$99.70
|
| Rate for Payer: Frontpath All Products |
$75.40
|
| Rate for Payer: Humana ChoiceCare |
$83.08
|
| Rate for Payer: Lucent/Coldwater Veneers |
$72.39
|
| Rate for Payer: Lutheran Preferred All Products |
$66.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$62.31
|
| Rate for Payer: PHP All Products |
$54.00
|
| Rate for Payer: Plain Church Group Ministry All Products |
$42.58
|
| Rate for Payer: Signature Care EPO |
$73.66
|
| Rate for Payer: Signature Care PPO |
$73.66
|
| Rate for Payer: Three Rivers Preferred All Products |
$62.00
|
| Rate for Payer: United Healthcare Commercial |
$50.08
|
|
|
CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE
|
Professional
|
$25.20
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
Z12971
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$30.24 |
| Rate for Payer: Anthem Exchange |
$5.94
|
| Rate for Payer: Anthem PPO |
$5.94
|
| Rate for Payer: Anthem Traditional |
$5.94
|
| Rate for Payer: Coventry/First Health All Products |
$30.24
|
| Rate for Payer: Frontpath All Products |
$12.60
|
| Rate for Payer: Humana ChoiceCare |
$25.20
|
| Rate for Payer: Lutheran Preferred All Products |
$18.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$18.90
|
| Rate for Payer: PHP All Products |
$11.09
|
| Rate for Payer: Signature Care EPO |
$16.92
|
| Rate for Payer: Signature Care PPO |
$16.92
|
| Rate for Payer: Three Rivers Preferred All Products |
$16.00
|
| Rate for Payer: United Healthcare Commercial |
$8.98
|
|
|
CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE
|
Professional
|
$25.20
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
Z12972
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$30.24 |
| Rate for Payer: Anthem Exchange |
$5.94
|
| Rate for Payer: Anthem PPO |
$5.94
|
| Rate for Payer: Anthem Traditional |
$5.94
|
| Rate for Payer: Coventry/First Health All Products |
$30.24
|
| Rate for Payer: Frontpath All Products |
$12.60
|
| Rate for Payer: Humana ChoiceCare |
$25.20
|
| Rate for Payer: Lutheran Preferred All Products |
$18.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$18.90
|
| Rate for Payer: PHP All Products |
$11.09
|
| Rate for Payer: Signature Care EPO |
$16.92
|
| Rate for Payer: Signature Care PPO |
$16.92
|
| Rate for Payer: Three Rivers Preferred All Products |
$16.00
|
| Rate for Payer: United Healthcare Commercial |
$8.98
|
|
|
CHG FETAL BIOPHYSICAL PROFILE
|
Professional
|
$215.28
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
Z12952
|
| Min. Negotiated Rate |
$110.19 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna Medicare |
$110.33
|
| Rate for Payer: Anthem Exchange |
$110.19
|
| Rate for Payer: Anthem Medicare |
$110.33
|
| Rate for Payer: Anthem PPO |
$110.19
|
| Rate for Payer: Anthem Traditional |
$110.19
|
| Rate for Payer: Caresource Just 4 Me |
$126.88
|
| Rate for Payer: Caresource Medicare |
$121.36
|
| Rate for Payer: Centivo/Paragon All Products |
$171.01
|
| Rate for Payer: Coventry/First Health All Products |
$258.34
|
| Rate for Payer: Frontpath All Products |
$189.70
|
| Rate for Payer: Humana ChoiceCare |
$215.28
|
| Rate for Payer: Humana Medicare |
$110.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$187.56
|
| Rate for Payer: Lutheran Preferred All Products |
$171.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$161.46
|
| Rate for Payer: PHP All Products |
$139.93
|
| Rate for Payer: Plain Church Group Ministry All Products |
$110.33
|
| Rate for Payer: Signature Care EPO |
$141.10
|
| Rate for Payer: Signature Care PPO |
$141.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$160.00
|
| Rate for Payer: United Healthcare Commercial |
$111.96
|
|
|
CHG FETAL BIOPHYSICAL PROFILE
|
Professional
|
$215.28
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
Z12951
|
| Min. Negotiated Rate |
$110.19 |
| Max. Negotiated Rate |
$258.34 |
| Rate for Payer: Aetna Medicare |
$110.33
|
| Rate for Payer: Anthem Exchange |
$110.19
|
| Rate for Payer: Anthem Medicare |
$110.33
|
| Rate for Payer: Anthem PPO |
$110.19
|
| Rate for Payer: Anthem Traditional |
$110.19
|
| Rate for Payer: Caresource Just 4 Me |
$126.88
|
| Rate for Payer: Caresource Medicare |
$121.36
|
| Rate for Payer: Centivo/Paragon All Products |
$171.01
|
| Rate for Payer: Coventry/First Health All Products |
$258.34
|
| Rate for Payer: Frontpath All Products |
$189.70
|
| Rate for Payer: Humana ChoiceCare |
$215.28
|
| Rate for Payer: Humana Medicare |
$110.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$187.56
|
| Rate for Payer: Lutheran Preferred All Products |
$171.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$161.46
|
| Rate for Payer: PHP All Products |
$139.93
|
| Rate for Payer: Plain Church Group Ministry All Products |
$110.33
|
| Rate for Payer: Signature Care EPO |
$141.10
|
| Rate for Payer: Signature Care PPO |
$141.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$160.00
|
| Rate for Payer: United Healthcare Commercial |
$111.96
|
|
|
CHG FETAL BIOPHYS PROF,W/O NST
|
Professional
|
$155.46
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
Z12953
|
| Min. Negotiated Rate |
$79.67 |
| Max. Negotiated Rate |
$186.55 |
| Rate for Payer: Aetna Medicare |
$79.67
|
| Rate for Payer: Anthem Exchange |
$95.96
|
| Rate for Payer: Anthem Medicare |
$79.67
|
| Rate for Payer: Anthem PPO |
$95.96
|
| Rate for Payer: Anthem Traditional |
$95.96
|
| Rate for Payer: Caresource Just 4 Me |
$91.62
|
| Rate for Payer: Caresource Medicare |
$87.64
|
| Rate for Payer: Centivo/Paragon All Products |
$123.49
|
| Rate for Payer: Coventry/First Health All Products |
$186.55
|
| Rate for Payer: Frontpath All Products |
$138.75
|
| Rate for Payer: Humana ChoiceCare |
$155.46
|
| Rate for Payer: Humana Medicare |
$79.67
|
| Rate for Payer: Lucent/Coldwater Veneers |
$135.44
|
| Rate for Payer: Lutheran Preferred All Products |
$123.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$116.59
|
| Rate for Payer: PHP All Products |
$101.05
|
| Rate for Payer: Plain Church Group Ministry All Products |
$79.67
|
| Rate for Payer: Signature Care EPO |
$122.40
|
| Rate for Payer: Signature Care PPO |
$122.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$116.00
|
| Rate for Payer: United Healthcare Commercial |
$86.53
|
|
|
CHG FETAL BIOPHYS PROF,W/O NST
|
Professional
|
$155.46
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
Z12954
|
| Min. Negotiated Rate |
$79.67 |
| Max. Negotiated Rate |
$186.55 |
| Rate for Payer: Aetna Medicare |
$79.67
|
| Rate for Payer: Anthem Exchange |
$95.96
|
| Rate for Payer: Anthem Medicare |
$79.67
|
| Rate for Payer: Anthem PPO |
$95.96
|
| Rate for Payer: Anthem Traditional |
$95.96
|
| Rate for Payer: Caresource Just 4 Me |
$91.62
|
| Rate for Payer: Caresource Medicare |
$87.64
|
| Rate for Payer: Centivo/Paragon All Products |
$123.49
|
| Rate for Payer: Coventry/First Health All Products |
$186.55
|
| Rate for Payer: Frontpath All Products |
$138.75
|
| Rate for Payer: Humana ChoiceCare |
$155.46
|
| Rate for Payer: Humana Medicare |
$79.67
|
| Rate for Payer: Lucent/Coldwater Veneers |
$135.44
|
| Rate for Payer: Lutheran Preferred All Products |
$123.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$116.59
|
| Rate for Payer: PHP All Products |
$101.05
|
| Rate for Payer: Plain Church Group Ministry All Products |
$79.67
|
| Rate for Payer: Signature Care EPO |
$122.40
|
| Rate for Payer: Signature Care PPO |
$122.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$116.00
|
| Rate for Payer: United Healthcare Commercial |
$86.53
|
|
|
CHG GLUCOSE BLOOD TEST
|
Professional
|
$6.56
|
|
|
Service Code
|
CPT 82962
|
| Hospital Charge Code |
Z12980
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$7.87 |
| Rate for Payer: Anthem Exchange |
$1.97
|
| Rate for Payer: Anthem PPO |
$1.97
|
| Rate for Payer: Anthem Traditional |
$1.97
|
| Rate for Payer: Coventry/First Health All Products |
$7.87
|
| Rate for Payer: Frontpath All Products |
$3.28
|
| Rate for Payer: Humana ChoiceCare |
$6.56
|
| Rate for Payer: Lutheran Preferred All Products |
$5.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$4.92
|
| Rate for Payer: PHP All Products |
$2.89
|
| Rate for Payer: Signature Care EPO |
$3.40
|
| Rate for Payer: Signature Care PPO |
$3.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$4.00
|
| Rate for Payer: United Healthcare Commercial |
$3.42
|
|
|
CHG GLYCOSYLATED HEMOGLOBIN, HOME DEVICE
|
Professional
|
$19.42
|
|
|
Service Code
|
CPT 83037
|
| Hospital Charge Code |
Z12983
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$23.30 |
| Rate for Payer: Coventry/First Health All Products |
$23.30
|
| Rate for Payer: Frontpath All Products |
$9.71
|
| Rate for Payer: Humana ChoiceCare |
$19.42
|
| Rate for Payer: Lutheran Preferred All Products |
$14.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$14.57
|
| Rate for Payer: PHP All Products |
$8.54
|
| Rate for Payer: Signature Care EPO |
$16.51
|
| Rate for Payer: Signature Care PPO |
$16.51
|
| Rate for Payer: Three Rivers Preferred All Products |
$13.00
|
| Rate for Payer: United Healthcare Commercial |
$14.17
|
|
|
CHG GLYCOSYLATED HEMOGLOBIN, HOME DEVICE
|
Professional
|
$19.42
|
|
|
Service Code
|
CPT 83037
|
| Hospital Charge Code |
Z12984
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$23.30 |
| Rate for Payer: Coventry/First Health All Products |
$23.30
|
| Rate for Payer: Frontpath All Products |
$9.71
|
| Rate for Payer: Humana ChoiceCare |
$19.42
|
| Rate for Payer: Lutheran Preferred All Products |
$14.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$14.57
|
| Rate for Payer: PHP All Products |
$8.54
|
| Rate for Payer: Signature Care EPO |
$16.51
|
| Rate for Payer: Signature Care PPO |
$16.51
|
| Rate for Payer: Three Rivers Preferred All Products |
$13.00
|
| Rate for Payer: United Healthcare Commercial |
$14.17
|
|
|
CHG GLYCOSYLATED HEMOGLOBIN TEST
|
Professional
|
$19.42
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
Z12981
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$23.30 |
| Rate for Payer: Coventry/First Health All Products |
$23.30
|
| Rate for Payer: Frontpath All Products |
$9.71
|
| Rate for Payer: Humana ChoiceCare |
$19.42
|
| Rate for Payer: PHCS/Multiplan All Products |
$14.57
|
| Rate for Payer: PHP All Products |
$8.54
|
| Rate for Payer: United Healthcare Commercial |
$8.50
|
|
|
CHG GLYCOSYLATED HEMOGLOBIN TEST
|
Professional
|
$19.42
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
Z12982
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$23.30 |
| Rate for Payer: Coventry/First Health All Products |
$23.30
|
| Rate for Payer: Frontpath All Products |
$9.71
|
| Rate for Payer: Humana ChoiceCare |
$19.42
|
| Rate for Payer: PHCS/Multiplan All Products |
$14.57
|
| Rate for Payer: PHP All Products |
$8.54
|
| Rate for Payer: United Healthcare Commercial |
$8.50
|
|
|
CHG HEMOGLOBIN
|
Professional
|
$4.74
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
Z12986
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$5.69 |
| Rate for Payer: Coventry/First Health All Products |
$5.69
|
| Rate for Payer: Frontpath All Products |
$2.37
|
| Rate for Payer: Humana ChoiceCare |
$4.74
|
| Rate for Payer: Lutheran Preferred All Products |
$3.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$3.56
|
| Rate for Payer: PHP All Products |
$2.09
|
| Rate for Payer: Signature Care EPO |
$3.40
|
| Rate for Payer: Signature Care PPO |
$3.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$3.00
|
| Rate for Payer: United Healthcare Commercial |
$3.46
|
|
|
CHG HEMOGLOBIN
|
Professional
|
$4.74
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
Z12987
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$5.69 |
| Rate for Payer: Coventry/First Health All Products |
$5.69
|
| Rate for Payer: Frontpath All Products |
$2.37
|
| Rate for Payer: Humana ChoiceCare |
$4.74
|
| Rate for Payer: Lutheran Preferred All Products |
$3.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$3.56
|
| Rate for Payer: PHP All Products |
$2.09
|
| Rate for Payer: Signature Care EPO |
$3.40
|
| Rate for Payer: Signature Care PPO |
$3.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$3.00
|
| Rate for Payer: United Healthcare Commercial |
$3.46
|
|
|
CHG HETEROPHILE ANTIBODIES,SCREEN
|
Professional
|
$10.36
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
Z12988
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$12.43 |
| Rate for Payer: Anthem Exchange |
$2.45
|
| Rate for Payer: Anthem PPO |
$2.45
|
| Rate for Payer: Anthem Traditional |
$2.45
|
| Rate for Payer: Coventry/First Health All Products |
$12.43
|
| Rate for Payer: Frontpath All Products |
$5.18
|
| Rate for Payer: Humana ChoiceCare |
$10.36
|
| Rate for Payer: Lutheran Preferred All Products |
$7.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$7.77
|
| Rate for Payer: PHP All Products |
$4.56
|
| Rate for Payer: Signature Care EPO |
$6.80
|
| Rate for Payer: Signature Care PPO |
$6.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$7.00
|
| Rate for Payer: United Healthcare Commercial |
$7.56
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
$33.10
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
Z13002
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$39.72 |
| Rate for Payer: Coventry/First Health All Products |
$39.72
|
| Rate for Payer: Frontpath All Products |
$16.55
|
| Rate for Payer: Humana ChoiceCare |
$33.10
|
| Rate for Payer: Lutheran Preferred All Products |
$23.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$24.83
|
| Rate for Payer: PHP All Products |
$14.56
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$22.00
|
| Rate for Payer: United Healthcare Commercial |
$17.52
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
$33.10
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
Z13003
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$39.72 |
| Rate for Payer: Coventry/First Health All Products |
$39.72
|
| Rate for Payer: Frontpath All Products |
$16.55
|
| Rate for Payer: Humana ChoiceCare |
$33.10
|
| Rate for Payer: Lutheran Preferred All Products |
$23.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$24.83
|
| Rate for Payer: PHP All Products |
$14.56
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$22.00
|
| Rate for Payer: United Healthcare Commercial |
$17.52
|
|
