|
HC CT BRAIN WO CON
|
Facility
|
OP
|
$1,514.14
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Aetna Commercial |
$1,287.02
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cofinity Commercial |
$1,059.90
|
| Rate for Payer: Cofinity Commercial |
$1,302.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,362.73
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,287.02
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,287.02
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.19
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$953.91
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,120.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$1,120.46
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT BRAIN WO CON
|
Facility
|
IP
|
$1,514.14
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$953.91 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Aetna Commercial |
$1,287.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.19
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cofinity Commercial |
$1,059.90
|
| Rate for Payer: Cofinity Commercial |
$1,302.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.31
|
| Rate for Payer: Healthscope Commercial |
$1,362.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,287.02
|
| Rate for Payer: PHP Commercial |
$1,287.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.19
|
| Rate for Payer: Priority Health SBD |
$953.91
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
OP
|
$1,825.90
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,643.31 |
| Rate for Payer: Aetna Commercial |
$1,552.02
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cofinity Commercial |
$1,570.27
|
| Rate for Payer: Cofinity Commercial |
$1,278.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,278.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,643.31
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,552.02
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,552.02
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.84
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,150.32
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,351.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,351.17
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
IP
|
$1,825.90
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,150.32 |
| Max. Negotiated Rate |
$1,643.31 |
| Rate for Payer: Aetna Commercial |
$1,552.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.84
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cofinity Commercial |
$1,278.13
|
| Rate for Payer: Cofinity Commercial |
$1,570.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,278.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.72
|
| Rate for Payer: Healthscope Commercial |
$1,643.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,552.02
|
| Rate for Payer: PHP Commercial |
$1,552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.84
|
| Rate for Payer: Priority Health SBD |
$1,150.32
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
IP
|
$2,068.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,302.84 |
| Max. Negotiated Rate |
$1,861.20 |
| Rate for Payer: Aetna Commercial |
$1,757.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.20
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,447.60
|
| Rate for Payer: Cofinity Commercial |
$1,778.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,447.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,654.40
|
| Rate for Payer: Healthscope Commercial |
$1,861.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.80
|
| Rate for Payer: PHP Commercial |
$1,757.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health SBD |
$1,302.84
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
OP
|
$2,068.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,861.20 |
| Rate for Payer: Aetna Commercial |
$1,757.80
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,778.48
|
| Rate for Payer: Cofinity Commercial |
$1,447.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,447.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,654.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,861.20
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.80
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,757.80
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,302.84
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,530.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,530.32
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$454.53 |
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Cofinity Commercial |
$353.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$353.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$429.28
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$318.17
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$373.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$373.72
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
IP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$318.17 |
| Max. Negotiated Rate |
$454.53 |
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.27
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$353.52
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$353.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: PHP Commercial |
$429.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: Priority Health SBD |
$318.17
|
|
|
HC CT CHEST WITH CON
|
Facility
|
IP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,094.40 |
| Max. Negotiated Rate |
$1,563.43 |
| Rate for Payer: Aetna Commercial |
$1,476.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.15
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,216.01
|
| Rate for Payer: Cofinity Commercial |
$1,493.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,216.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Healthscope Commercial |
$1,563.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: PHP Commercial |
$1,476.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health SBD |
$1,094.40
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,563.43 |
| Rate for Payer: Aetna Commercial |
$1,476.58
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,493.95
|
| Rate for Payer: Cofinity Commercial |
$1,216.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,216.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,563.43
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,476.58
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,094.40
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,285.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,285.49
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$953.88 |
| Max. Negotiated Rate |
$1,362.68 |
| Rate for Payer: Aetna Commercial |
$1,286.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.16
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,059.86
|
| Rate for Payer: Cofinity Commercial |
$1,302.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Commercial |
$1,362.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: PHP Commercial |
$1,286.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health SBD |
$953.88
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,362.68 |
| Rate for Payer: Aetna Commercial |
$1,286.98
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,302.12
|
| Rate for Payer: Cofinity Commercial |
$1,059.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,362.68
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,286.98
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$953.88
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,120.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$1,120.43
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,850.34 |
| Rate for Payer: Aetna Commercial |
$1,747.54
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,768.10
|
| Rate for Payer: Cofinity Commercial |
$1,439.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,439.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,850.34
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,747.54
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,295.24
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,521.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,521.39
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,295.24 |
| Max. Negotiated Rate |
$1,850.34 |
| Rate for Payer: Aetna Commercial |
$1,747.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.35
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,439.15
|
| Rate for Payer: Cofinity Commercial |
$1,768.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,439.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Healthscope Commercial |
$1,850.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: PHP Commercial |
$1,747.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health SBD |
$1,295.24
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$869.66 |
| Max. Negotiated Rate |
$1,242.37 |
| Rate for Payer: Aetna Commercial |
$1,173.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.27
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,187.15
|
| Rate for Payer: Cofinity Commercial |
$966.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$966.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Healthscope Commercial |
$1,242.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health SBD |
$869.66
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,242.37 |
| Rate for Payer: Aetna Commercial |
$1,173.35
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$966.29
|
| Rate for Payer: Cofinity Commercial |
$1,187.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$966.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,242.37
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$869.66
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,021.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$1,021.50
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$196.09
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$438.63 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
| Rate for Payer: UHC Core |
$811.47
|
| Rate for Payer: UHC Exchange |
$811.47
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$690.85 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,002.78 |
| Max. Negotiated Rate |
$1,432.54 |
| Rate for Payer: Aetna Commercial |
$1,352.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.61
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,114.20
|
| Rate for Payer: Cofinity Commercial |
$1,368.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,114.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Healthscope Commercial |
$1,432.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: PHP Commercial |
$1,352.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: Priority Health SBD |
$1,002.78
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,432.54 |
| Rate for Payer: Aetna Commercial |
$1,352.95
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,368.87
|
| Rate for Payer: Cofinity Commercial |
$1,114.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,114.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,432.54
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,352.95
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,002.78
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,177.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,177.87
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,269.79 |
| Rate for Payer: Aetna Commercial |
$1,199.25
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,213.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$987.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,269.79
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,199.25
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$888.85
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,044.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$1,044.05
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$888.85 |
| Max. Negotiated Rate |
$1,269.79 |
| Rate for Payer: Aetna Commercial |
$1,199.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.07
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,213.36
|
| Rate for Payer: Cofinity Commercial |
$987.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$987.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Healthscope Commercial |
$1,269.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: PHP Commercial |
$1,199.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: Priority Health SBD |
$888.85
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$944.17 |
| Max. Negotiated Rate |
$1,348.82 |
| Rate for Payer: Aetna Commercial |
$1,273.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.15
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,049.08
|
| Rate for Payer: Cofinity Commercial |
$1,288.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,049.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Healthscope Commercial |
$1,348.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: PHP Commercial |
$1,273.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health SBD |
$944.17
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,348.82 |
| Rate for Payer: Aetna Commercial |
$1,273.89
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,049.08
|
| Rate for Payer: Cofinity Commercial |
$1,288.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,049.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,348.82
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,273.89
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$944.17
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,109.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$1,109.03
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$97.75
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
IP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$912.59 |
| Max. Negotiated Rate |
$1,303.69 |
| Rate for Payer: Aetna Commercial |
$1,231.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.56
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,013.99
|
| Rate for Payer: Cofinity Commercial |
$1,245.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,303.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: PHP Commercial |
$1,231.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: Priority Health SBD |
$912.59
|
|
